Details of a Researcher - Tamura, Noriko

Papers - Tamura, Noriko

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投稿論文研究報告精神科医療機関における集団精神療法の実施状況に関する全国調査

田島美幸, 藤澤大介, 田村法子, 近藤裕美子, 原祐子, 大嶋伸雄, 岡島美朗, 岡田佳詠, 菊地俊暁, 耕野敏樹, 佐藤泰憲, 高橋章郎, 中川敦夫, 中島美鈴, 吉永尚紀, 大野裕

精神療法 ((株)金剛出版) 50 ( 4 ) 563 - 571 2024.08

ISSN 09168710

精神科医療機関における集団精神療法の実施状況に関する全国調査

精神療法 ((株)金剛出版) 50 ( 4 ) 563 - 571 2024.08

ISSN 0916-8710

本研究では,全国の精神科医療機関3,734施設に対して集団精神療法の施行実態や課題を調査した。回答施設数は730件(回収率19.6%),無効回答2件を除く728件を解析対象とした。集団精神療法を実施する施設は201件(27.6%)であった。1施設あたり平均4.2(SD=6.7)の集団精神療法を実施し,平均時間は77.2分(SD=35.1),平均回数は9.2回(SD=6.3),平均参加人数は8.2人(SD=5.3),平均スタッフ数は2.4人(SD=1.4)であった。対象疾患はうつ病が128件(63.7%),統合失調症が110件(54.7%),発達障害が107件(53.2%)の順に多かった。用いる手法は心理教育が139件(69.2%),認知行動療法が128件(63.7%),社会生活スキルトレーニングが120件(59.7%)等であった。コスト算定方法は精神科デイケア/ナイトケアが92件(45.8%),精神科ショートケアが73件(36.3%),通院集団精神療法が53件(26.4%)等であった。実施施設の約半数が自施設の集団精神療法の充足度を低く評価し,労力やコストが報酬に見合わない,職員の人数不足,職員が集団精神療法に従事する時間がない,スキルを持った職員がいない等を課題に挙げた。本調査の限界に回収率の低さが挙げられ,解釈には注意を要する。更なる分析を加え,詳細な実態を把握する必要がある。(著者抄録)

連載認知症者・家族をさまざまな観点や立場から支えるコミュニケーションスキル・第6回認知行動療法の観点から

田村法子

総合リハビリテーション (株式会社医学書院) 52 ( 2 ) 179 - 185 2024.02

ISSN 03869822

第5土曜特集アルツハイマー病--研究と治療の最前線臨床・治療薬認知症診療における患者・家族への非薬物的アプローチ

田村法子, 三村將

医学のあゆみ (医歯薬出版) 287 ( 13 ) 1069 - 1074 2023.12

ISSN 00392359

Impact of continued mindfulness practice on resilience and well-being in mindfulness-based intervention graduates during the COVID-19 pandemic: A cross-sectional study

Tanaka C., Wakaizumi K., Ninomiya A., Tamura N., Kosugi S., Park S., Sado M., Mimura M., Fujisawa D.

Psychiatry and Clinical Neurosciences Reports (Psychiatry and Clinical Neurosciences Reports) 2 ( 3 ) e132 2023.09

ISSN 2769-2558

Aim: The coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented stress. Mindfulness-based interventions (MBIs) are known to be effective in reducing stress. However, it is unclear how long-term outcomes differ between those who continue mindfulness practice after MBIs and those who do not. In this study, we hypothesized that those who continued mindfulness practice would have higher stress tolerance, and we examined this hypothesis through a survey of MBI graduates. In this study, we examined the association between the continuation of mindfulness practice among MBI completers and individual stress during the COVID-19 epidemic. Methods: A cross-sectional survey of MBI graduates was conducted. The physical and mental health states were compared between those who established a habit of mindfulness practice (practice group) and those who did not (no practice group). Results: The data were collected from 95 participants (response rate: 53.7%). Of the total respondents, 66 (69.5%) practiced mindfulness. Although the degree of perceived stress due to the COVID-19 pandemic was not statistically different between the practice and no practice groups, the practice group showed significantly lower levels of depression (p = 0.007), higher levels of resilience (p = 0.006), higher levels of overall health (p = 0.006), and higher levels of mental health (p = 0.039). The effect of mindfulness practice on reducing depression was fully mediated by resilience. Conclusion: Among MBI graduates, those who regularly practiced mindfulness had lower levels of depression and higher levels of physical and mental health. Thus, the continuation of mindfulness practice increases resilience, buffers against new stressors such as the COVID-19 pandemic, and has the potential to prevent depression.

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Group multi-component programme based on cognitive behavioural therapy and positive psychology for family caregivers of people with dementia: a randomised controlled study (3C study)

Tamura N.T., Shikimoto R., Nagashima K., Sato Y., Nakagawa A., Irie S., Iwashita S., Mimura M., Fujisawa D.

Psychogeriatrics (Psychogeriatrics) 23 ( 1 ) 141 - 156 2023.01

ISSN 13463500

Background: Caregivers of people with dementia frequently experience an elevated level of psychological distress and burden. This study aimed to examine the effectiveness of a group-format multi-component programme which is based on cognitive behavioural therapy and positive psychology. Methods: Family caregivers of dementia were allocated (1:1) to the intervention group and the wait-list control group, stratified by age (<65 years, ≥65 years) and care status (at home or in an institution). The intervention group received a six-session, 10-week, group-format programme. The primary outcome was the Hospital Anxiety Depression Scale (HADS). Secondary outcomes were the short-version of the Zarit Burden Interview (personal strain and role strain), Neuropsychiatric Inventory Questionnaire, Dementia Caregiver Positive Feeling Scale, and Self-Compassionate Reactions Inventory. The evaluations were conducted at baseline, 10 weeks (post-intervention), and 14 weeks (follow-up). Results: The analyses were performed with 64 registered participants. In the whole sample, no significant effect was observed on HADS. There was medium effect on role strain (P = 0.04, partial η2 = 0.08). Positive feelings of caregiving increased after the intervention but were not maintained at follow-up. In the subgroup analysis of caregivers under 65 years of age, a statistically significant effect was observed for personal strain (P = 0.03, partial η2 = 0.16). An interaction effect was also found for the total score of positive feelings of caregiving (P < 0.05, partial η2 = 0.02) and the meaning of caregiving (P = 0.02, partial η2 = 0.10). Conclusions: This programme did not show significant improvement in depression and anxiety of caregivers of dementia; however, it reduced the burden of their role conflict (role strain) and yielded favourable short-term effects on the positive feelings and the meaning of caregiving among the participants. Also, the programme effectively reduced the personal strain of caregivers under 65 years.

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特集こころの臨床現場からの発信"いま"をとらえ、精神療法の可能性を探る (第1部)臨床現場からの声　精神療法の可能性を探る　本邦における集団精神療法の現状と課題

藤澤大介, 田島美幸, 田村法子, 近藤裕美子, 大嶋伸雄, 岡島美朗, 岡田佳詠, 菊地俊暁, 耕野敏樹, 佐藤泰憲, 高橋章郎, 中川敦夫, 中島美鈴, 横山貴和子, 吉永尚紀, 大野裕

精神療法 ((株)金剛出版) 48 ( 7 ) 98 - 103 2022.06

ISSN 09168710

Predictors and moderators of outcomes in mindfulness-based cognitive therapy intervention for early breast cancer patients

Tamura N., Park S., Sato Y., Sato Y., Takita Y., Ninomiya A., Sado M., Mimura M., Fujisawa D.

Palliative and Supportive Care (Palliative and Supportive Care) 20 ( 2 ) 159 - 166 2022.04

ISSN 14789515

Objectives To deliver mindfulness-based cognitive therapy (MBCT) efficiently, the present study aimed (1) to identify predictors and moderators of patients who benefit from MBCT for psychological distress and (2) to explore the initial treatment reaction to identify the optimal number of sessions that produce a significant clinical effect. Methods This is the secondary analysis of a randomized controlled trial of MBCT for breast cancer patients (N = 74). We classified the participants into remitters vs. non-remitters, and responder vs. non-responders, according to the total score of the Hospital Anxiety and Depression Scale at the end of the intervention. We conducted multivariate analyses to explore for predictors of response and remission. We adopted generalized estimating equations to explore the optimal number of sessions. Results Sociodemographic and clinical backgrounds did not have significant influence on the treatment outcomes of the MBCT. Better program adherence, which was represented as the participants' better attendance to the MBCT program, was a significant predictor of both remission and response [odds ratio (OR) = 1.90, 95% confidence interval (CI) 1.25-2.89, p = 0.003, and OR = 1.72, 95% CI 1.12-2.65, p = 0.013, respectively]. It was not until seventh session that the remission rate exceeded 50% and the response rate showed significance. Significance of results Sociodemographic and clinical characteristics did not significantly influence the treatment outcomes, while homework minutes and class attendance had significant effects on treatment outcomes. This implies that MBCT is recommended to any cancer patient, if he/she is motivated to the program, regardless of their sociodemographic and clinical characteristics. Patients are encouraged to attend a standard MBCT program (eight sessions) and do the assigned homework as intensely as possible. Further studies with larger sample and objective measurements are desired.

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特集認知症診療における精神科医の役割を再考する認知症家族介護者に対する認知行動療法

藤澤大介, 田島美幸, 田村法子, 色本涼

精神医学 (株式会社医学書院) 63 ( 8 ) 1223 - 1230 2021.08

ISSN 04881281

The Significance and Future of Mindfulness-based Interventions in Psychiatry and Mental Health: Focusing on the Current Situation and Issues in Japan

Sado Mitsuhiro, Ninomiya Akira, Park Sunre, Tanaka Chisato, Kosugi Teppei, Tamura Noriko, Nagaoka Maki, Yamada Masashi, Fujisawa Daisuke

JAPANESE PSYCHOLOGICAL REVIEW (JAPANESE PSYCHOLOGICAL REVIEW) 64 ( 4 ) 555 - 578 2021

ISSN 03861058

<p>Since the development of mindfulness-based cognitive therapy (MBCT), which integrates cognitive-behavioral therapy and mindfulness-based stress reduction, its effectiveness in preventing the recurrence of depression has been demonstrated. Mindfulness-based interventions (MBIs) such as MBCT and mindfulness-based stress reduction have rapidly spread in the field of psychiatry and mental health. To date, MBIs have been proven as effective for treating depression, anxiety, addiction, cancer, chronic pain, etc. Interventions to improve mental health are also spreading in the field of school education and business. Based on these backgrounds, we first reviewed the development of MBCT and its basic structure as an example of MBI. We then overviewed the effects of MBIs on each condition (e.g., depression, anxiety, psycho-oncology), followed by the current status and issues relevant to MBIs in Japan. Finally, we discussed the challenges regarding MBIs in Japan such as verifying the effects of nonstandardized MBIs and clarifying the mechanisms of effects and the measures for dissemination.</p>

Mindfulness-Based Cognitive Therapy for Psychological Distress, Fear of Cancer Recurrence, Fatigue, Spiritual Well-Being, and Quality of Life in Patients With Breast Cancer-A Randomized Controlled Trial.

Park S, Sato Y, Takita Y, Tamura N, Ninomiya A, Kosugi T, Sado M, Nakagawa A, Takahashi M, Hayashida T, Fujisawa D

Journal of pain and symptom management 60 ( 2 ) 381 - 389 2020.08

ISSN 0885-3924

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FOCUS 認知症家族介護者の認知行動療法START(家族のための戦略)プログラム:基礎編

藤澤大介, 色本涼, 田村法子, 石川博康, 田島美幸

保健師ジャーナル (株式会社医学書院) 75 ( 2 ) 148 - 152 2019.02

ISSN 13488333

Mindfulness-based cognitive therapy improved depression, anxiety, fear of cancer recurrence, fatigue, and QoL in patients with breast cancer - a randomized control trial

Fujisawa, D; Park, S; Sato, Y; Sado, M; Takita, Y; Tamura, N; Takeuchi, M; Nakagawa, A; Ninomiya, A; Kosugi, T

PSYCHO-ONCOLOGY 27 146 - 146 2018.10

ISSN 1057-9249

Web-Based Cognitive Behavioral Therapy Blended With Face-to-Face Sessions for Major Depression: Randomized Controlled Trial.

Nakao S, Nakagawa A, Oguchi Y, Mitsuda D, Kato N, Nakagawa Y, Tamura N, Kudo Y, Abe T, Hiyama M, Iwashita S, Ono Y, Mimura M

Journal of medical Internet research 20 ( 9 ) e10743 2018.09

ISSN 1439-4456

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Challenges of Mindfulness Based Cognitive Therapy

Sado Mitsuhiro, Ninomiya Akira, Kosugi Teppei, Park Sunre, Sato Yasuko, Takita Yuka, Tamura Noriko, Takeuchi Mari, Fujisawa Daisuke

Japanese Journal of Mindfulness (Japanese Association of Mindfulness) 2 ( 2 ) 58 - 65 2018

Application of Mindfulness-Based Interventions to Cancer and Palliative Care Settings in Keio University Hospital

Fujisawa Daisuke, Park Sunre, Sato Yasuko, Takita Yuka, Tamura Noriko, Takeuchi Mari, Hashiguchi Saori, Kosugi Teppei, Ninomiya Akira, Sado Mitsuhiro

Japanese Journal of Mindfulness (Japanese Association of Mindfulness) 2 ( 2 ) 50 - 57 2018

大学病院におけるマインドフルネス認知療法の取り組み：不安障害、well-beingを中心に

PARK Sunre, TAMURA Noriko, Fujisawa Daisuke

マインドフルネス研究 3 2018

Accepted

【精神医療・精神医学に関するガイドラインの現状と問題点】わが国における精神医療・精神医学ガイドラインの現状

田村法子

精神神経学雑誌 ((公社)日本精神神経学会) 119 ( 3 ) 151 - 157 2017.03

ISSN 0033-2658

診療ガイドラインは,わが国においては「診療上の重要度の高い医療行為について,エビデンスのシステマティックレビューとその総体評価,益と害のバランスなどを考量して,患者と医療者の意思決定を支援するために最適と考えられる推奨を提示する文書」と定義されている.適切に利用すれば,現場での臨床判断が円滑・効率化,社会的にみれば臨床行為のばらつきの改善,患者アウトカム,医療の質を向上させるといわれている.診療ガイドライン策定後は普及,評価,改訂というステップが重要であるが,わが国において普及,評価に関する情報は少ない.そのため,現状把握の一歩として,現在刊行されている診療ガイドラインの情報収集を行った.検索データベースには,Mindsウェブサイト,東邦大学・医中誌診療ガイドライン情報データベース,J-GLOBALを用いた.3つのデータベースで該当した合計数1,117件から重複や海外版などを除外すると,78件が該当した.78件の疾患,作成者/団体,発行年,作成方法,発行形態,改訂の有無について調査分類した.調査結果から,ガイドラインが多数存在すること,必ずしも入手が容易でないこと,使用されているのか(普及,実施しているのか)不明なことが浮かびあがった.また,診療ガイドラインが作成される際に用いられるエビデンスにはシンプルな症例を対象とした臨床研究が多いが,実臨床では複雑な症例が多いこと,現代では,いくつかの慢性疾患各々が病態生理的に関連するしないにかかわらず並存している状態であるマルチモビディティの問題があり,診療ガイドラインの実施が難しい面もある.しかし,精神医療・精神医学においては普及や実施に関する報告は少なく,円滑な医学情報の発信と医療の質向上に向けて今後の検討が待たれる.(著者抄録)

慶應義塾大学病院におけるがん・緩和ケア領域のマインドフルネス介入の取り組み．

Fujisawa Daisuke, PARK Sunre, TAMURA Noriko, SADO Mitsuhiro

マインドフルネス研究 2(2) 2017

Accepted

The reliability and validity of the Japanese version of the Temperament and Personality Questionnaire for patients with non-melancholic depression.

Kudo Y, Nakagawa A, Tamura N, Kato N, Williams A, Aida N, Mimura M

Journal of affective disorders 198 237 - 41 2016.07

ISSN 0165-0327

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