Osaka, Wakako

写真a

Affiliation

Faculty of Nursing and Medical Care (Shonan Fujisawa)

Position

Associate Professor

External Links

Career 【 Display / hide

  • 2005.04
    -
    2007.03

    聖路加看護大学, 成人看護学, 助手

  • 2007.04
    -
    2012.03

    聖路加看護大学, 成人看護学, 助教

  • 2015.10
    -
    2020.03

    St. Luke’s International University, 客員研究員

  • 2016.04
    -
    2018.12

    Jikei University, Faculty of Medicine School of Nursing, 講師

  • 2019.01
    -
    Present

    Keio University, Faculty of Nursing and Medical Care, 准教授

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Research Areas 【 Display / hide

  • Life Science / Clinical nursing

Research Keywords 【 Display / hide

  • Cancer Nursing

  • がん看護学

  • サポートグループ

  • ディシジョンエイド

  • ピアサポート

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Books 【 Display / hide

  • ドレーン&チューブ管理マニュアル : 特定行為に役立つ : 臨床に活かせる

    永井 秀雄, 佐田 尚宏, 中村 美鈴, 学研メディカル秀潤社, 学研プラス (発売), 2019

  • これから始める!シェアード・ディシジョンメイキング : 新しい医療のコミュニケーション

    中山 健夫, 日本医事新報社, 2017

  • 乳がん診療聖路加スタイル : 最高のチーム医療をめざして

    北野 敦子, 山内 英子, 中外医学社, 2012

Papers 【 Display / hide

  • Influence of participation in a medical-themed Science Café on patient activation

    Yuta Okazawa, Hayato Kizaki, Nobuyuki Suzuki, Wakako Osaka, Satoko Hori

    Patient Preference Adherence (Patient Preference and Adherence)  17   3093 - 3106 2023.11

    Accepted,  ISSN  1177-889X

     View Summary

    Purpose: This study aims to investigate the impact of a Science Café (SC) dealing with medical topics on participants’ patient activation (PA), a concept that refers to patients’ involvement in managing their own health, working with their healthcare providers, and maintaining their health. Material and Methods: Semi-structured interviews were conducted with patients who had participated in a medical SC (n = 10) to identify the medical SC-associated factors that influenced PA. Through a questionnaire of medical SC participants (n = 23), the impact on PA and correlations with relevant psychological measures were quantitatively assessed. Results: The interviews revealed three factors: “Experience & acceptance of chronic conditions”, “Features of medical SC” and “Changes as a result of participation.” The questionnaire results showed a positive correlation between PA and resilience and a negative correlation with decision regret. Conclusions: Participation in a medical SC by people with illnesses can improve PA by improving knowledge and skills for self-management and increasing self-awareness of illness in a supportive environment. The study highlights the potential benefits of using medical SC as a strategy for healthcare providers to improve PA and health outcomes.

  • Development and acceptability of a decision aid for women with a BRCA pathogenic variant considering cancer risk management strategies

    Okawa Megumi, Osaka Wakako

    Journal of Hereditary Tumors (The Japanese Society for Hereditary Tumors)  22 ( 1 ) 9 - 16 2022.08

    Research paper (scientific journal), Joint Work, Accepted

     View Summary

     Women with a BRCA pathogenic variant are required to manage the risk of breast and ovarian cancer. Decision-making of the optimal strategy (e.g., prophylactic surgery, chemoprevention, or surveillance) is very complex and difficult due to uncertain effects and impact. This study aimed to develop a decision aid for women with a <i>BRCA</i> pathogenic variant and evaluate its acceptability. The International Patient Decision Aids Standards were used as a guide for an evidence-based development process. We created a prototype using the Ottawa Decision Support framework. During its development, we conducted required assessment from six experts. Once completed, its acceptability was assessed via semi-structured interviews, which included open-ended feedback, with 27 women with a <i>BRCA</i> pathogenic variant. All the participants felt the decision aid would have been helpful during their consultation and recommended it for future patients. However, many participants indicated the need for further information regarding the various symptoms after risk-reducing salpingo-oophorectomy and the cost of each medical strategy. Acceptability of the decision aid was high. Furthermore, based on the evaluation, it was further revised to meet the needs.

  • Shared decision making, physicians’ explanations, and treatment satisfaction: a cross-sectional survey of prostate cancer patients

    Kazuhiro Nakayama, Wakako Osaka, Nobuaki Matsubara, Tsutomu Takeuchi, Mayumi Toyoda, Noriyuki Ohtake, Hiroji Uemura

    BMC Medical Informatics and Decision Making (Springer Science and Business Media LLC)  20 ( 1 ) 334 - 334 2020.12

    Research paper (scientific journal), Joint Work, Accepted

     View Summary

    <title>Abstract</title><sec>
    <title>Background</title>
    Hormone therapy is one option for some types of prostate cancer. Shared decision making (SDM) is important in the decision making process, but SDM between prostate cancer patients receiving hormone therapy and physicians is not fully understood. This study tested hypotheses: “Patients’ perception of SDM is associated with treatment satisfaction, mediated by satisfaction with physicians’ explanations and perceived effective decision making” and “The amount of information provided to patients by physicians on diseases and treatment is associated with treatment satisfaction mediated by patients’ perceived SDM and satisfaction with physicians’ explanations.”


    </sec><sec>
    <title>Methods</title>
    This cross-sectional study was conducted using an online panel via a private research company in Japan. The participants in this study were patients registered with the panel who had received or were currently receiving hormone therapy for prostate cancer and physicians registered with the panel who were treating patients with prostate cancer. Measures used in this study included a nine-item Shared Decision Making Questionnaire, levels of satisfaction with physicians’ explanations and treatment satisfaction, and effective decision making for patients (feeling the choice is informed, value-based, likely to be implemented and expressing satisfaction with the choice), and a Shared Decision Making Questionnaire for Doctors. The hypotheses were examined using path analysis.


    </sec><sec>
    <title>Results</title>
    In total, 124 patients and 150 physicians were included in the analyses. In keeping with our hypotheses, perceived SDM significantly correlated with the physicians’ explanations and perceived effective decision making for patients, and satisfaction with physicians’ explanations and perceived effective decision making for patients were both related to treatment satisfaction. Although the amount of information provided to patients was correlated with the perceived SDM, it was indirectly related to their satisfaction with physicians’ explanations.


    </sec><sec>
    <title>Conclusions</title>
    When physicians encourage patients to be actively involved in making decisions about treatment through the SDM process while presenting a wide range of information at the start of hormone therapy, patients’ effective decision making and physicians’ explanations may be improved; consequently, the patients’ overall treatment satisfaction may be improved. Physicians who treat patients with prostate cancer may have underestimated the importance of SDM before starting hormone therapy, even greater extent than patients.


    </sec>

  • Effect of a decision aid on the choice of pregnant women whether to have epidural anesthesia or not during labor

    Eri Shishido, Wakako Osaka, Ayame Henna, Yuko Motomura, Shigeko Horiuchi

    PLOS ONE (Public Library of Science (PLoS))  15 ( 11 ) e0242351 - e0242351 2020.11

    Research paper (scientific journal), Joint Work, Accepted

     View Summary

    <sec id="sec001">
    <title>Objective</title>
    Decision aids (DAs) are useful in providing information for decision-making on using epidural anesthesia during birth. To date, there has been little development of DAs for Japanese pregnant women. Herein, we investigated the effect of a DA on the decision of pregnant women whether to have epidural anesthesia or not for labor during vaginal delivery. The primary outcome was changes in mean decision conflict score.


    </sec>
    <sec id="sec002">
    <title>Methods</title>
    In this non-randomized controlled trial, 300 low-risk pregnant women in an urban hospital were recruited by purposive sampling and assigned to 2 groups: DA (intervention) and pamphlet (control) groups. Control enrollment was started first (until 150 women), followed by intervention enrollment (150 women). Pre-test and post-test scores were evaluated using the Decision Conflict Scale (DCS) for primary outcome, knowledge of epidural anesthesia and satisfaction with decision making for secondary outcomes, and decision of anesthesia usage (i.e., with epidural anesthesia, without epidural anesthesia, or undecided).


    </sec>
    <sec id="sec003">
    <title>Results</title>
    Women in the DA group (n = 149: 1 excluded because she did not return post-test questionnaire) had significantly lower DCS score than those in the pamphlet group (n = 150) (DA: -8.41 [SD 8.79] vs. pamphlet: -1.69 [SD 5.91], p &lt; .001). Knowledge of epidural anesthesia and satisfaction with decision-making scores of women who used the DA were significantly higher than those of women who used the pamphlet (p &lt; .001). Women in the DA group showed a significantly lower undecided rate than those in the pamphlet group. The number of undecided women in the DA group significantly decreased from 30.2% to 6.1% (p &lt; .001), whereas that in the pamphlet group remained largely unchanged from 40.7% to 38.9%.


    </sec>
    <sec id="sec004">
    <title>Conclusion</title>
    This study indicates that a DA can be useful in helping women make a decision whether to have epidural anesthesia or not for labor during vaginal delivery.


    </sec>

  • 意思決定の葛藤をアセスメントするスクリーニングツールSURE test日本語版の開発 言語的妥当性を踏まえた翻訳版の作成

    大坂 和可子, 青木 頼子, 江藤 亜矢子, 北 奈央子, 有森 直子, 中山 和弘

    日本看護科学会誌 ((公社)日本看護科学学会)  39   334 - 340 2019.12

    ISSN  0287-5330

     View Summary

    目的:本研究の目的は,患者の意思決定の葛藤をスクリーニングするSURE(Sure of myself;Understand information;Risk-benefit ratio;Encouragement)test日本語版を,言語的妥当性を踏まえ開発することである.方法:SURE test日本語版は,第1段階:2名による順翻訳,第2段階:順翻訳統合,第3段階:2名による逆翻訳,第4段階:研究者協議(暫定版作成),第5段階:一般市民,医療者への調査,第6段階:再検討,を経て開発した.結果:暫定版作成後,第5段階の一般市民と医療者32名の調査において,「わかりやすい」と回答した割合は各項目で47%から78%であった.第6段階にて言語的妥当性を再検討し,日本語版を確定した.結論:一連の過程を経て,言語的妥当性を踏まえたSURE test日本語版を開発した.(著者抄録)

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Papers, etc., Registered in KOARA 【 Display / hide

Reviews, Commentaries, etc. 【 Display / hide

  • 患者のヘルスリテラシーに考慮したシェアードディシジョンメイキング ディシジョンエイド活用の有用性

    大坂 和可子

    日本乳癌学会総会プログラム抄録集 ((一社)日本乳癌学会)  31回   50 - 50 2023.06

  • がん患者の持つ力に沿った意思決定支援のアウトカム ディシジョンエイドを活用した意思決定支援におけるアウトカム

    大坂 和可子

    日本がん看護学会学術集会 ((一社)日本がん看護学会)  37回   36 - 36 2023.02

  • 【乳房再建マニュアル-根治性、整容性、安全性に必要な治療戦略-】基礎編 個々の患者に最適な乳房再建を選択するためのshared decision making

    素輪 善弘, 大坂 和可子

    PEPARS ((株)全日本病院出版会)   ( 183 ) 47 - 55 2022.03

    ISSN  1349-645X

     View Summary

    近年、日本の乳房再建は変容と多様化が進み、脂肪移植術を含めた自家組織とインプラントを様々な組み合わせで適応していくオーダーメイド化した個別医療が加速している。一方で治療方針が複雑化していく懸念もあり、個人に合った再建法の最適化が次なる課題となっている。また最近では、患者が治療方針決定に積極的に参加できるよう支援し、決定プロセスを共有しながら、患者と医療者が協働的に治療法を決めていくshared decision making(SDM)という新しい意思決定スタイルが注目されている。SDMは、乳癌治療や乳房再建医療においても重要性を増しており、選択肢に関する中立的で正確な情報、様々な価値観を示し、患者自身が能動的に決定を進めること促すdecision aids(DA)を活用することで円滑かつ有効にSDMを促進することができる。SDMを適切に実践していくためには、本邦においても、質の高いDAの開発が急がれる。(著者抄録)

  • 個々の患者に最適な乳房再建を選択するためのshared decision making

    OSAKA Wakako

    ペパーズ(PEPARS; Perspective Essential Plastic Aesthetic reconstructive Surgery) 183号 ( 183 ) 47 - 55 2022.03

  • 患者中心の意思決定を支えるツール ーディシジョンエイドの開発・活用・普及・教育ー

    大坂 和可子

    聖路加看護学会誌 25 ( 2 ) 42 - 45 2022.01

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Presentations 【 Display / hide

  • 患者と医療者が意思決定プロセスを共有するための方略-価値観を明確にするディシジョ ンエイドの活用-

    青木裕見, 大坂和可子, 青木頼子, 藤田美保, 有森直子, 中山和弘

    第43回日本看護科学学会学術集会, 

    2023.12

    Other

  • HBOCリスク低減乳房切除術選択時の説明内容、Shared Decision Makingと意思決定の葛藤および後悔の関連

    鈴木 美慧, 大坂 和可子, 大川 恵, 金井 久子, 喜多 久美子, 竹井 淳子, 林 直樹, 吉田 敦, 山中 美智子, 山内 英子

    第31回日本乳癌学会総会, 

    2023.06
    -
    2023.07

    Oral presentation (general), (一社)日本乳癌学会

  • 教育講演「患者中心の意思決定を支えるツール ディシジョンエイドの開発・活用・普及・教育」

    大坂 和可子

    第26回聖路加看護学会学術大会, 

    2021.11

    Oral presentation (invited, special)

  • シンポジウムⅡ. 医療における当事者・家族意思決定支援の実装「がん医療における意思決定ガイドを活用した意思決定支援の実装に向けた取り組みと課題」

    大坂 和可子

    第40回日本看護科学学会学術集会, 

    2020.12

    Symposium, workshop panel (nominated)

  • シンポジウム2 多様性を理解し、支える医療コミュニケーション 「Shared Decision Makingを促進する意思決定ガイドの活用」

    大坂 和可子

    第12回日本ヘルスコミュニケーション学会学術集会, 

    2020.09

    Symposium, workshop panel (nominated)

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Research Projects of Competitive Funds, etc. 【 Display / hide

  • がん患者の主体的な意思決定参加を促すSDMの組織定着を目指す実装モデルの構築

    2022.04
    -
    2026.03

    日本学術振興会, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

     View Summary

    本研究は、がん患者の主体的な意思決定参加を促すSDMが組織内に定着し、患者の意思決定の質を組織レベルで向上することを目指し、①がん医療におけるSDMの障壁となる要因と促進要因を明らかにすること、② ①の結果を踏まえ、障壁となる要因を取り除き、促進要因を強化するための実装モデルを構築すること、③ ②で構築した実装モデルに対するがん医療に携わる医療者による受容性と有用性の認識の程度、および実装モデルの改善点にはどのようなものがあるかを明らかにすること、を目的とする。

  • 「複雑な意思決定」を支援するわかりやすいディシジョンエイドのチェックリスト開発

    2020.07
    -
    2023.03

    St. Luke's International University, Grants-in-Aid for Scientific Research, Grant-in-Aid for Challenging Research (Exploratory), No Setting

     View Summary

    本研究の目的は、先進国で広く利用が進んできている患者中心の意思決定を支援するツールであるディシジョンエイド(decision aid)において、エビデンスが不十分で長所(利益)と短所(リスク)の不確実性が高い場合に、自分の価値観を中心に決める必要がある「複雑な意思決定」を、よりシンプルで、親しみやすく、わかりやすくするために必要な要件を探り、ディシジョンエイドのチェックリストを作成することである。ディシジョンエイドにおいて、日本人の半分が、確率情報の比較及び選択が困難な可能性があり、価値観の明確化を可能にする方法に関するエビデンスもない。わかりやすい方法を当事者への調査から明らかにする。

  • 日本人に不足するヘルスリテラシーを前提から支える意思決定スキル学習コンテンツ開発

    2020.04
    -
    2024.03

    St. Luke's International University, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), No Setting

     View Summary

    本研究の目的は健康を決める力ヘルスリテラシー(HL)の根幹をなす、判断・意思決定が困難な日本人並びにその支援者の看護職に、HLの前提となる意思決定のスキルを学習するツール開発である。国際比較研究では日本人はEUやアジアよりHLが低く、死亡率の低下が鈍化し、慢性疾患の管理も悪く、喫煙率や自殺率は高く、警鐘が鳴らされている。しかし日本人は学校教育や生涯教育において、意思決定できることが幸せであること、その基本的な方法として選択肢を探し、それぞれの長所と短所を比較し自分の価値観に合ったものを選ぶことを学習する機会がない。これは意思決定を支援する看護職でも同様で、共にそれらを学び合うことを可能にする。

  • Development of an educational program on the systematic development and use of decision aids for healthcare professionals in oncology

    2018.04
    -
    2022.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, OSAKA Wakako, Grant-in-Aid for Scientific Research (C), Principal investigator

     View Summary

    In this study, we developed and evaluated the acceptability of a web-based educational program on the systematic development and use of decision aids (DA) for healthcare professionals in oncology. Based on a needs assessment of healthcare professionals and information about existing educational programs, we designed a web-based educational program available to healthcare professionals not only in oncology but also in a variety of specialties. We conducted an acceptability study. A total of 4o participants completed the post-program acceptability survey. 90% of the participants were satisfied with the program. In addition, 90% of the participants indicated that they would like to use DA and 60% of the participants indicated that they would like to develop DA. Our findings suggest that this web-based educational program could improve learners' intentions to develop and use DA.

  • Intervention study of a shared decision-making educational program to reduce ethical conflict in obstetric care facilities

    2017.04
    -
    2022.03

    Niigata University, Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (B), Arimori Naoko, Grant-in-Aid for Scientific Research (B), No Setting

     View Summary

    Objective: To clarify the reality of shared decision-making (SDM) in obstetrics and to evaluate SDM educational programs for healthcare professionals. Methods: (1) Web-based survey and interviews on SDM, and (2) evaluation of the program. Results: (1) Fifty-three healthcare professionals responded to the web survey (February 2021). The older they were and the more years of experience they had, the more they practiced SDM. 7 interviewees revealed problems and responses to SDM that support decision-making for both the expectant mother and the fetus, as well as situations requiring IP-SDM and responses. (2) The educational program (in October of the same year) was attended by 13 participants from two facilities. The "individual study" received high formative evaluations and the "group study" was conducted as planned, suggesting its feasibility of the program in clinical practice.

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Works 【 Display / hide

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Awards 【 Display / hide

  • SFC FACULTY AWARD 2021

    2022.03, 慶應義塾大学湘南藤沢キャンパス

  • 平成29年度看護学研究奨励賞

    2019.07, 一般社団法人日本私立看護系大学協会, 「Effect of a decision aid with patient narratives in reducing decisional conflict in choice for surgery among early-stage breast cancer patients: A three-arm randomized controlled trial」

  • 第10回看護のアイディアde賞「IT de 賞」

    2019.07, 国際モダンホスピタルショウ2017

  • 平成23年度日本がん看護学会学術奨励賞(教育・実践部門)

    2012.02

 

Courses Taught 【 Display / hide

  • TERMINAL CARE NURSING

    2023

  • SENIOR PROJECT 2

    2023

  • SENIOR PROJECT 1

    2023

  • SEMINAR IN TERMINAL CARE

    2023

  • SEMINAR IN CHRONIC CARE

    2023

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Courses Previously Taught 【 Display / hide

  • 成人発達援助論

    Keio University

    2022
    -
    Present

  • フィジカルアセスメント

    Keio University

    2019
    -
    Present

  • プロジェクトⅡ(応用)

    Keio University

    2019
    -
    Present

  • プロジェクトⅠ(基礎)

    Keio University

    2019
    -
    Present

  • 医療システムアプローチ実践

    Keio University

    2019
    -
    Present

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Media Coverage 【 Display / hide

Committee Experiences 【 Display / hide

  • 2021.10
    -
    Present

    KOMPAS編集委員, 慶應義塾大学病院 医療・健康情報サイト(Keio hospital information and patient assistance service; KOMPAS)

  • 2019.04
    -
    2021.04

    ガイドライン委員会 委員, 日本がん看護学会

  • 2018.06
    -
    Present

    学会誌編集委員会 委員, 聖路加看護学会

  • 2015.07
    -
    2017.06

    広報委員会 委員, 日本看護科学学会