Details of a Researcher - Haruta, Junji

Papers - Haruta, Junji

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特集語りたい!総合診療のエビデンス日本発! 総合診療医が作るエビデンス質的研究:医学生は地域の臨床実習でSDH をどのように学ぶのか?

春田淳志

治療 (南山堂) 106 ( 9 ) 1054 - 1058 2024.09

ISSN 00225207

Characteristics of the studies using realist evaluation to assess interventions that address psychosocial healthcare issues in older adults: a scoping review

S Mitani, H Ogawara, J Haruta, T Sakakibara, H Fukahori

BMJ open 14 (8), e078256 14 ( 8 ) e078256 2024.08

ISSN 2044-6055

Objectives Interventions to address psychosocial healthcare issues in older adults are increasing. Realist evaluation (RE) helps us understand how these interventions work for their issues. It is significant to obtain implications for further developing such research. We aimed to identify the characteristics of studies using RE to assess interventions that address psychosocial healthcare issues in older adults by mapping relevant literature. Design Scoping review. Data sources MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, Cochrane Library, ICHUSHI (a Japanese database) and Google Scholar were used for searches between 5 January 2022 and 4 January 2024. Eligibility criteria (1) Showing that most of the participants were older adults or their stakeholders; (2) stating in the research background or aim sections that the target interventions aimed at addressing older adults’ psychosocial healthcare issues and (3) using RE to assess these interventions. Data extraction Data on country of origin, type of research, study design, qualitative data collection and analysis methods, desirable items for RE and intervention aims and purposes were extracted and summarised using descriptive statistics. Results Fifty-four studies were analysed. Most studies were conducted in the UK (54.5%). Mixed methods were used in 28 studies (51.9%), while only qualitative methods were used in 25 studies (46.2 %). Fourteen intervention aims and purposes were identified: improving dementia care, avoiding emergency admissions, preventing social isolation and promoting family involvement in the care of older adults. Conclusion RE is useful for promoting an understanding of how interventions work for addressing psychosocial healthcare issues in older adults. RE also promotes the updating of plausible theories that lead to improving interventions. Our findings show the implications of managing time and resources to address the challenge of RE’s time and resource intensiveness and carefully considering the data collection methods to reduce burdens on older adults.

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総合的に患者・生活者をみるために必要なコンピテンシーとは医学教育モデル・コア・カリキュラムへの新設

藤川裕恭, 安藤崇之, 遠藤周, 金子惇, 鋪野紀好, 長嶺由衣子, 中山健夫, 錦織宏, 山梨啓友, 春田淳志

日本プライマリ・ケア連合学会学術大会 ((一社)日本プライマリ・ケア連合学会) 15回 333 - 333 2024.06

総合的に患者・生活者をみるために必要なコンピテンシーとは医学教育モデル・コア・カリキュラムへの新設

藤川裕恭, 安藤崇之, 遠藤周, 金子惇, 鋪野紀好, 長嶺由衣子, 中山健夫, 錦織宏, 山梨啓友, 春田淳志

日本プライマリ・ケア連合学会学術大会 ((一社)日本プライマリ・ケア連合学会) 15回 333 - 333 2024.06

アレルギー領域における診療科・職種横断的リカレント教育の重要性　「出前授業による教育の機会創出事業」参加者データの分析

正木克宜, 坂下雅文, 小川靖, 猪俣武範, 貝沼圭吾, 神尾敬子, 佐藤さくら, 玉利真由美, 中島沙恵子, 森田英明, 倉島洋介, 二村昌樹, 高橋浩一郎, 春田淳志, 百武美沙, 門川俊明, 石塚全, 意元義政, 尾山徳孝, 神崎晶, 木戸口正典, 福島敦樹, 福永興壱, 藤枝重治, 安冨素子, 足立剛也, 免疫アレルギー疾患研究10か年戦略次世代タスクフォース(ENGAGE-TF)

アレルギー ((一社)日本アレルギー学会) 73 ( 4 ) 329 - 339 2024.06

ISSN 0021-4884

【背景】多職種・複数診療科が関与するアレルギー診療水準の向上には,専門医以外も対象とした教育の必要性が考えられるが,そのニーズ調査と方法に関する検討は不十分である.【目的・方法】免疫アレルギー疾患研究10か年戦略次世代タスクフォース(ENGAGE-TF)は学会支援下に慶應義塾大学,福井大学と連携した複数回のバーチャル教育企画「出前授業」を企画した.そのニーズと有用性を検証するため,SNSや各大学・医師会等を通じて周知し,メーリングリストを用いてアンケート調査を行った.【結果】のべ1139人・回より回答を得た.半数以上が専門医以外の医師であり,幅広い医療関連職種も参加した.7割が「とても満足」,6割以上が「ちょうどよい」難易度と回答した.自由記載の感想から,職種毎の学びの焦点,経験年数による学びのスタンスの違いが見られた.【考察・結語】9割を占める専門医以外の参加者のプライマリケアにおけるアレルギー疾患対応ニーズの高さと,経験11年以上の医療関連職種の遠隔教育・リカレント教育の有用性が示唆された.(著者抄録)

Impact of University Hospital Clinical Clerkship on Medical Students' Understanding of the Specialties in General Medicine

Ando Takayuki, Hyakutake Misa, Haruta Junji, Fujikawa Hirohisa, Hirahashi Junichi, Fujishima Seitaro

An Official Journal of the Japan Primary Care Association (JAPAN PRIMARY CARE ASSOCIATION) 47 ( 2 ) 63 - 66 2024.06

ISSN 2185-2928

大学病院における総合診療科の臨床実習において医学生が総合診療の専門性をどのように理解しているのかを明らかにするために，実習前後の「総合診療の専門性とは？」というアンケートの自由記載に対して内容分析を行った．大学病院での臨床実習を通して，診断学だけではなく心理・社会的側面を踏まえた診療や健康維持なども総合診療の専門性であることが学生により獲得されていることが明らかになった．

Association of polydoctoring and mortality among very old persons with multimorbidity: a prospective cohort study in Japan

T Ando, T Sasaki, Y Abe, Y Nishimoto, T Hirata, T Tajima, Y Oguma, ...

BJGP open 8 ( 3 ) 2024.04

Background: Polydoctoring can increase the risk of care fragmentation among patients with multimorbidity, but its impact on health outcomes remains unclear. Aim: To determine the effects of polydoctoring, as measured by the regularly visited facilities (RVF) indicator, on patient outcomes among older individuals with multimorbidity. Design & setting: Data from the ongoing prospective cohort study, Kawasaki Aging and Wellbeing Project (KAWP), was utilised in this study. Among the 1026 KAWP participants aged 85–89 years, those with two or more chronic conditions were enrolled in this study. Method: Care fragmentation and polydoctoring was evaluated using the RVF, which is a new indicator that measures the number of medical facilities consistently involved in a patient’s care. Based on RVF, mortality was analysed using the Cox proportional hazards model, with adjustments for age, sex, frailty, and number of comorbidities. Results: A significant reduction in mortality rates was observed in participants with an RVF of ≥3 and 2–4 comorbidities (hazard ratio [HR] 0.43, 95% confidence interval [CI] = 0.18 to 0.99, P value = 0.048). However, no significant difference in mortality based on RVF was observed for those with ≥5 comorbidities. Notably, individuals with ≥5 comorbidities and an RVF of 0 had a significantly higher HR for death (HR 2.68, 95% CI = 1.05 to 6.84, P value = 0.039). Conclusion: In older patients with multimorbidity, polydoctoring may reduce mortality in patients with ≤4 coexisting conditions, but it does not significantly impact mortality in those with ≥5 conditions. These findings provide insights for healthcare decision making in managing older patients with multimorbidity.

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Exploring factors associated with healthcare professionals' subjective perceptions of complex issues in primary care in Japan: a self-administered survey study on confidence, satisfaction and burden levels.

Haruta J, Goto R

BMJ open 14 ( 3 ) e081328 2024.03

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医療者教育学専攻修士課程の導入期に地域診断・フィールドワークを教育の一環として実施する意義 : 教員の視点でのふりかえり (<特集>大学と地域創生)

川上ちひろ, 後藤亮平, 今福輪太郎, 西城卓也, 早川佳穂, 春田淳志

Collaborative Study with Community (地域協学センター) 8 112 - 119 2024.03

ISSN 24328545

CiNii Research

特集総合理学療法総合的に患者・生活者をみる姿勢と多職種連携能力-モデル・コア・カリキュラムから紐解く

春田淳志

理学療法ジャーナル (株式会社医学書院) 58 ( 2 ) 166 - 171 2024.02

ISSN 09150552

Laypeople's Perspective on Physician Work-Hour Restrictions in Japan: A Cross-Sectional Study

H Fujikawa, J Haruta

Journal of Patient Experience 11, 23743735241305337 11 23743735241305337 2024.01

ISSN 23743735

The aim of the study was to examine laypeople's perspectives on the impending implementation of physician work-hour restrictions in Japan, which had received limited research attention. We conducted a nationwide cross-sectional study in January 2024. The participants were monitors of an internet survey company who responded to closed questions regarding the expected effect of work-hour regulations, along with an open-ended question regarding their expectations or concerns about these restrictions. The data were analyzed using descriptive statistics for closed questions and content analysis for the open-ended questions. The study included 484 laypeople. A significant portion (25.4%) was unaware of the scheduled start of work-hour restrictions. Approximately half of the participants had a neutral view of the overall impact of the restrictions. Content analysis of the open-ended responses identified 130 (60.2%) comments as “expectations” and 70 (32.4%) as expressing “concerns,” with a notable number of comments deemed to indicate that the respondents were “unsure” or found the changes “irrelevant” to them. This study indicates a substantial gap between the views of physicians and laypeople on this issue.

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Decision-making Support and Patients’ Care Progress in a Palliative Care Outpatient Clinic at a Community Hospital

Osawa Gakuji, Haruta Junji, Matsuura Miyuki, Ueno Akika, Den Naoko

Palliative Care Research (Japanese Society for Palliative Medicine) 19 ( 1 ) 7 - 12 2024

Purpose: This study aimed to investigate the decision-making support and patients’ care progress in a palliative care outpatient clinic at a community hospital. Methods: We conducted a retrospective examination of patients who visited our palliative care outpatient clinic and subsequently died between January 2020 and December 2021. The clinic, staffed by two palliative care physicians, operated twice weekly and accepted patients irrespective of their treatment status. Result: 93 patients were included in the analysis. At the onset of the outpatient clinic, 72 patients were asked about their preferred location for end-of-life care should their condition deteriorate. Of these, 25 patients preferred to receive end-of-life care in a palliative care unit (“PCU” group). Another 25 patients initially sought medical treatment at home through home-visits but later expressed a preference for care in a palliative care unit as their condition worsened (“home-visit→PCU” group). Additionally, 17 patients preferred home care from the end-of-life until death (“home-visit” group). Among the “PCU” patients, 96% received care in a palliative care unit, and 84% passed away in the same unit. In the “home-visit→PCU” group, 76% received care through home visit, and 80% passed away in a palliative care unit. In the “home-visit” group, 76% of patients received care at home, and 47% passed away in their own homes. Conclusion: These findings suggest that delivering end-of-life care in patients’ preferred locations is feasible with continuous decision-making support provided in the palliative care outpatient clinic.

Re: Letter to the Editor of Public Health in response to'Effect of influenza vaccine subsidies for older adults on vaccination coverage and mortality before and during the …

T Ando, Y Ibuka, R Goto, J Haruta, DD Le, S Fujishima

Public health, S0033-3506 (23) 00489-4 2024

Exploring factors associated with healthcare professionals’ subjective perceptions of complex issues in primary care in Japan: a self-administered survey study on confidence …

J Haruta, R Goto

BMJ Open 14 (3), e081328 2024

Author reply to the definition and evaluation of uncoordinated involvement of multiple healthcare providers;“Polydoctoring” as a component of care fragmentation among patients …

T Ando, T Sasaki, Y Abe, Y Nishimoto, T Hirata, J Haruta, Y Arai

Journal of General and Family Medicine 25 (2), 116 2024

Culture and context in Interprofessional education: Expectations in Australia and Japan

F Kent, J Haruta

Medical Education 59 ( 1 ) 83 - 87 2024

ISSN 03080110

The attributes of collaborative practice in health care vary across contexts, necessitating the adaptation of interprofessional education curricula to prepare students for the collaborative practice expected in their respective health care systems. Culture, when conceptualised through an organisational lens, allows an analysis of the shared assumptions, beliefs and values, without seeking to reduce to a uniform construct. This article explores the differences in interprofessional education competencies between Australia and Japan and considers the systems and patient expectations, which underpin each. While collaborative competence exhibits some similarities across contexts, competency frameworks differ in emphasis, language and key terminology, which highlight multiple points of difference in the expectations of interprofessional collaborative practice across contexts. There are education and practice consequences of these different perspectives of collaborative practice, in an increasingly mobile international workforce.

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RECURRENT AND VIRTUAL EDUCATION FOR ALL DISCIPLINES AND OCCUPATIONS IN THE ALLERGY REALM : A SURVEY OF THE PARTICIPANTS FROM THE INITIATIVE ‘OUTREACH LECTURES’ TO CREATE EDUCATIONAL OPPORTUNITIES

Masaki Katsunori, Sakashita Masafumi, Ogawa Yasushi, Inomata Takenori, Kainuma Keigo, Kan-o Keiko, Sato Sakura, Tamari Mayumi, Nakajima Saeko, Morita Hideaki, Kurashima Yosuke, Futamura Masaki, Takahashi Koichiro, Haruta Junji, Hyakutake Misa, Monkawa Toshiaki, Ishizuka Tamotsu, Imoto Yoshimasa, Oyama Noritaka, Kanzaki Sho, Kidoguchi Masanori, Fukushima Atsuki, Fukunaga Koichi, Fujieda Shigeharu, Yasutomi Motoko, Adachi Takeya

Japanese Journal of Allergology (Japanese Society of Allergology) 73 ( 4 ) 329 - 339 2024

ISSN 00214884

Background: In the enhancement of allergy care involving multidisciplinary and multiple medical departments, there is a perceived need for education that targets not only specialists but also non-specialists. However, research on the need for and methods of such education remains inadequate.Objective: To design a remote allergy care education program for all medical practitioners and to validate its necessity and utility.Methods: The Empowering Next Generation Allergist/immunologist toward Global Excellence Task Force (ENGAGE-TF), supported by the Japanese Society of Allergology, initiated a virtual educational program called ‘Outreach Lectures’ in collaboration with Keio University and Fukui University. This initiative was widely promoted through social media and various institutions, and a survey was conducted through its mailing list.Results: 1139 responses were obtained. More than half were physicians from non-allergy specialties, representing a diverse range of healthcare professions. Over 70% expressed being ‘very satisfied,’ and over 60% found the difficulty level ‘appropriate.’ Free-form feedback revealed differences in learning focus based on profession and learning approach based on years of experience.Conclusion: The high participation rate (90%) of non-specialist physicians underscores the demand for addressing allergic conditions in primary care. The effectiveness of virtual / recurrent education, particularly for healthcare professionals with over 11 years of experience, was implied. Further follow-up investigation focusing on quantitative and objective assessment of educational effectiveness is indispensable.

Re: Letter to the Editor of Public Health in response to ‘Effect of influenza vaccine subsidies for older adults on vaccination coverage and mortality before and during the …

T Ando, Y Ibuka, R Goto, J Haruta, DD Le, S Fujishima

Public Health 227, e3-e4 2024

Interprofessional competency in clinical students: validating the Clinical student version of the Japanese Self-assessment Scale of Interprofessional Competency (C-JASSIC)

J Haruta, E Tomizaki, T Horiguchi, T Nakamura, S Ishikawa, T Monkawa

Journal of Interprofessional Care, 1-8 38 ( 5 ) 1 - 8 2024

ISSN 13561820

In this study, we developed and validated the Clinical Student Version of the Japanese Interprofessional Competency Self-Assessment Scale (C-JASSIC) for healthcare students in their clinical practice phase. Data obtained from 331 students (medical, 98; nursing, 99; pharmacy, 134) during orientation for interprofessional education (pre-IPE) and from 319 students (medical, 94; nursing, 93; pharmacy, 132) within a week following IPE (post-IPE) were analyzed. Exploratory pre-IPE and Confirmatory post-IPE factor analyses revealed a consistent 6-factor structure aligning with the Japanese Interprofessional Competency domains. The scale exhibited strong internal consistency, with Cronbach’s α values exceeding 0.8 for all factors both pre- and post-IPE. Scores for overall competency and individual domains increased post-IPE in 234 matched cases. A notable significant pre vs post difference concerned “Understanding of Others,” indicating enhanced interprofessional comprehension after clinical practice. There was a weak but significant positive correlation between IPE satisfaction and difference in pre- and post-IPE scores. However, no significant differences were observed among medical, nursing, and pharmacy students. Despite its strengths, such as its competency-based design and cultural relevance to Japan, a limitation of the study may be potential self-reporting bias. Nonetheless, C-JASSIC represents a valuable tool for seamless competency evaluations from student to professional stages, with implications for broader Asian contexts.

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Community-based medical education (CBME), community comprehensive care education, and interprofessional education (IPE) in Japan: An exploration of their implementation

J Haruta

Medical Teacher 46 (sup1), S46-S52 46 ( sup1 ) S46 - S52 2024

ISSN 0142159X

Introduction: Medical education globally has evolved, with community-based medical education (CBME) and interprofessional education (IPE). This study aimed to explore the implementation of CBME, community comprehensive education, and IPE in Japan. Methods: A cross-sectional study was conducted across all Japanese medical universities in 2021. Data on CBME clinical clerkships, community comprehensive care education, and IPE were collected from 82 medical universities using a self-administered questionnaire and analyzed using descriptive statistics. Results: The study achieved a 100% response rate. 91.5% of universities offered CBME clinical clerkships, with 39.0% providing training periods up to 10 d. Outpatient practices were the primary CBME location in 90% of cases. 85.4% of institutions provided clinical care services, home medical care, and interprofessional collaboration. Direct observations were adopted 85.4% of the universities as an assessment method. Community comprehensive care education peaked in the fourth year (32.9%), while IPE was most prevalent in the first year (48.3%), followed by the fourth year (35.4%). Conclusion: This study, notable for its 100% response rate, highlights the significant incorporation of CBME. Future research should focus on the long-term effects, with recommendations for standardizing CBME curricula and enhancing staff development in a community to improve healthcare outcomes.

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