Designing a Scale to Assess Family Nursing Practice among Public Health Nurses in Japan

Background: The promotion of family nursing by public health nurses (PHN) presupposes an accurate assessment of the family nursing support they already provide. However, as there is no assessment tool for this purpose, this study aimed to develop a scale to assess family nursing currently provided by PHN. Methods: We developed the Family Nursing Practice Scale (FNPS) for PHN based on the results of a previous study. The content validity of the FNPS was established through discussion with three other researchers. A pilot study was conducted to confirm face validity. To confirm reliability and validity, an anonymous, self-reported questionnaire was sent to PHN working in municipal offices. The statistical analyses included the Kaiser-Meyer-Olkin (KMO), Barlett’s Test of Sphericity, exploratory factor analysis (EFA), Cronbach’s alpha, correlation coefficient and t-test. Results: Seven hundred fifty-four PHN participated in this study. Cronbach’s alpha of FNPS was 0.94. The KMO measure was 0.948, and Bartlett’s Test of Sphericity was p < 0.01. Two factors together accounted for 63.2% of the variance in EFA. No items were excluded because of low loadings. Construct validity was confirmed through comparison with categories from a previous study. The correlation coefficient of FNPS and selected items of the Practice of Breastfeeding Support Scale was r = 0.56 (p < 0.01). The result of the t-test showed that the FNPS score of PNH who had received training in family nursing was significantly higher than that of PHN who had not (t = -2.0;p < 0.05). Conclusion: The reliability and validity of the FNPS were confirmed. The FNPS comprised 15 items and two factors. The score for “Active support for the family” was lower than “Support given with awareness of the family’s situation.” The findings of this study strongly suggested that the FNPS would be effective in clarifying the current state of family nursing provided by PHN and factors related to this activity and thus greatly assist the efforts of PHN to promote family nursing.

Education Programs for Invasive Procedures Involving Nurses: A Scoping Review

Background: Implementing invasive procedures is an important part of patient management by clinical nurses;however, there are gaps between nurses’ actual knowledge and skills and expected professional care capacity. Purpose: This scoping review aimed to map the existing literature related to recent institution-provided educational programs for invasive procedures involving clinical nurses. This study seeks to understand the contents of educational programs and the methods for assessing educational effects. Methods: This scoping review was completed using the following four databases: PubMed (MEDLINE), Embase, Cochrane Library, and Emcare for the period 2000-2022. We included studies that used all forms of educational approaches (e.g., didactic lectures, hands-on training, or on-the-job training). This scoping review considered peer-reviewed publications published in English using quantitative, qualitative, or mixed approaches. A total of 83 studies underwent in the final analysis. Results and Conclusion: A combination of didactic lectures and hands-on training was provided as an educational program in most studies. Contrary to our prediction, educational interventions with advanced technologies such as VR are extremely rare, suggesting that the effectiveness of advanced technologies in learning invasive procedures should be examined to facilitate and retain educational effects more efficiently in future studies. Regarding the assessment of educational effects, nurses’ cognitive (i.e., theoretical knowledge about procedures), psychomotor (i.e., implementing procedures), and psychological aspects (e.g., confidence and self-efficacy in procedures) were evaluated using questionnaires and observational methods. While most studies used a one-group pretest-posttest design, the ratio of randomized controlled trials (RCT) was relatively low. Thus, an RCT design should be introduced in future studies to test the validity of the developed educational program more accurately.

Assessment of Quality of Life, Family Function and Family Empowerment for Families Who Provide Home Care for a Child with Severe Motor and Intellectual Disabilities in Japan

Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.

What Contributes to Satisfaction with Care for Family Caregivers of Terminal Cancer Patients Admitted to General Wards? A Qualitative Study

Satisfaction with care is an important indicator for family caregivers of patients with terminal cancer and is linked to the quality of life. Despite this, few studies have examined the aspects of satisfaction with care of family caregivers of inpatients with cancer in general wards. This qualitative study aimed to elucidate the elements of satisfaction with the care that inpatients with terminal cancer in general wards and their family caregivers receive from medical staff, as perceived by the family caregivers. Semi-structured interviews were conducted with 10 family caregivers of inpatients with terminal cancer. Participants were asked about the care received until then from medical staff, the features of satisfactory care, and the aspects of care they felt were unsatisfactory or could become satisfactory with improvement. The data were analyzed with the content analysis method and the six categories were extracted. For family caregivers of inpatients with terminal cancer in general wards, along with the care identified as important in palliative care, the methods of alleviating symptoms and explaining the patient’s condition were also important. The results highlight the importance of determining a patient-oriented approach and explanations together with each patient and family caregiver, based on an understanding of the long treatment process.

Clinical Competency: Simulation Compared with Lectures in Training Registered General Nursing (RGN) at Time of Completion of Program—A Systematic Review

Background: Advancing the science of nursing education through technology into teaching and learning is essential to prepare nurses for the changing healthcare environment. Objective: To synthesise evidence in nursing students’ competency in the clinical setting immediately after completion of training with simulation compared with lectures. Methods: Databases were sourced electronically from CINAHL and PubMed using keywords Simulation, lecture, clinical competency and new graduates. Study Eligibility Criteria, Participants and Interventions: Published articles addressing the research objectives, written in English, spaning between September 2010 and March 2019 directly answer the PSCOT question with results applicable to the population specific-nursing students, simulation was utilized. Study Appraisal and Synthesis Methods: Extracted data from sorted studies were analysed and assessed for quality using the John Hopkins Evidence-Based Appraisal Tools. Results: The two-database yielded 520 articles, 10 met the eligibility criteria. Findings documented three important themes: 1) Clinical competence among nurses;2) Medical residents’ clinical competence and 3) Was about the competence of anaesthesiology residents. Limitations: The identified studies used small sample sizes ranging from 20 to 98 participants in the single research studies. Conclusions: The review of the literature found that the active teaching strategy of simulation was more effective in promoting clinical competency in nursing students compared with the lecture method. The evidence-based teaching project proposes the use of simulation as the primary teaching method to improve the clinical competency abilities of registered general nursing (RGN) diploma students.

Relation between Family Functioning and Quality of Life among Family Caregivers of Patients with Terminal Cancer Hospitalized in General Wards

Caring for a patient with terminal cancer poses difficulties for family caregivers. Although families of patients with cancer have been classified by type, little is known about the relation between family functioning and quality of life (QOL) in family caregivers. This study aimed to develop a typology of family functioning in family caregivers of patients with terminal cancer and then examine the relation between the family functioning and QOL of family caregivers. From December 2013 to August 2014, fifty-one family caregivers of patients with terminal cancer were recruited at three hospitals in Tokyo, Japan. Perceptions of family functioning were assessed with the Family Relationship Index, and its three subscores were classified into three groups by cluster analysis. Caregivers’ QOL was measured with the Caregiver Quality of Life Index-Cancer. The average total FRI score among 51 caregivers was 8.5 (SD = 2.8). Family functioning was categorized into three clusters: supportive (n = 12), communicative (n = 30), or conflictive (n = 8). Their QOL was categorized into two groups: the communicative group, with relatively high confliction, showed high QOL comparable to the supportive group. Family functioning in the families of patients with terminal cancer hospitalized in general wards was not good. For improving the QOL of family caregivers, it may be important for the family members to express their feelings and distress if they have conflicts.

Future Long-Term Care Setting Preferences and Related Factors among Japanese Middle-Aged and Older People Living with HIV

Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and globally. Providing appropriate long-term care (LTC) for PLWH has thus become increasingly critical. Our study aimed to describe LTC setting preferences and related factors among middle-aged and older Japanese people living with HIV. A cross-sectional survey was conducted at two hospitals in Tokyo. One hundred seventy-five outpatients aged 40 years and above participated in this study. Participants completed an anonymous self-administered questionnaire to assess where they wanted to live once they could no longer care for themselves. Approximately 52.0% preferred a designated facility for older adults or LTC, while 30.3% preferred their home or living with family, a partner, or a friend (“familiar housing”). Bivariate analyses revealed that LTC setting preference was significantly associated with marital status, whether or not the participant had at least one child, and household composition. Furthermore, logistic regression analysis revealed that participants living with non-kin were less likely to prefer living in designated housing facilities for older adults or LTC (adjusted odds ratio = 0.17, 95% confidence interval: 0.05 - 0.63). The study findings suggest that family make-up and composition of cohabiters are critical indicators for LTC setting preference in this population. These findings can be the foundation for future care planning and delivery to meet the unique LTC needs and expectations of the aging population with HIV in Japan and similar global settings.

Factors influencing self-efficacy in breastfeeding support among public health nurses in Japan

This study investigated self-efficacy in breastfeeding support among public health nurses (PHNs) working at maternal and child health (MCH) services in Japanese municipalities, and its related factors such as education, working experience, breastfeeding experience, and postgraduate/continuous education. Directors of the MCH divisions were requested to select one PHN to answer the self-report questionnaires sent. The questionnaires were collected from October 2010 to January 2011. Of the 1750 questionnaires sent, 831 were returned (response rate: 47.5%);102 were excluded from analysis because of missing data (valid response rate: 41.7%). After adjusting the weights of PHN sampling and collection rates by prefecture and population size, Model 1 of the multiple regression analysis showed that the self-efficacy in breastfeeding support was significantly higher in large/urban municipalities (β = 0.13) and in the Kanto district. Model 2 revealed that self-efficacy was significantly associated with working experience (β = 0.13) and breastfeeding experience (β = 0.22) but not with educational background. Model 3 showed that self-efficacy was significantly associated with postgraduate education (β = 0.14) and continuous education (β = 0.12). This suggested that PHNs’ self-efficacy increased through self-enrichment. It is necessary to create training opportunities about breastfeeding support for PHNs—especially those working in remote and/or small municipalities— and to provide them with new and important information.

Approach to perinatal mental health and child abuse prevention in Japanese prefectural health centers

The aim of this study was to conduct a nationwide survey in Japan of prefectural health centers, which were responsible for providing guidance to municipalities. The survey was performed in order to clarify the following issues: 1) the current level of support provided by prefectural centers for pre-and post-natal mental health;2) the structures in place for providing consultation services for an “unwanted pregnancy” and the support available for high-risk cases;and 3) the advice available on postpartum maternal psychological screening, and interpretation of results of such screening. Questionnaires were sent by post to 394 prefectural health centers, of which 277 (70.3%) responded. A total of 32% of prefectural health centers confirmed that they had offered support to high-risk cases during pregnancy, and 72% had offered support post-partum. Regarding offering support to high-risk mothers, those prefectural health centers that did provide consultation services (n = 59) reported providing introductions and information about available facilities (P < 0.001) and conducting case conferences (P < 0.002). This was significantly different than prefectural health centers that did not provide consultation services (n = 198). At the prefectural health centers that “follow up on” the results of the mental health screening, psychiatry consultations were reported twice as often as the prefectural health centers that did “not follow up on” the results of mental health screening. These findings indicate that childcare support systems for postpartum mental health and the prevention of child abuse were established. However, the lack of prenatal health and support systems for the prenatal period remains an issue.

Qualitative Study of Breastfeeding Support by Public Health Nurses in Japan

This study aimed to explore breastfeeding support by public health nurses (PHNs) working in Japanese municipalities in order to promote a breastfeeding-friendly environment. We interviewed 20 participants including five PHNs, four midwives, four doctors (one obstetrician and three pediatricians), and seven mothers who experienced breastfeeding between June and August 2010 and analyzed the data using content analysis. Collected data were classified into four categories including “collecting information”, “assessment”, “direct and individual support”, and “support for group and community” with 15 subcategories: infant’s condition, mother’s condition, mother-infant relationship, child rearing environment, mother’s state-of-mind, identifying necessary support, psychological support, concrete support, breastfeeding on demand, necessary information, advice to supporters, introducing services, breastfeeding-friendly environment, breastfeeding support groups and cooperation with relevant organization. This study suggested that the PHNs’ responsibilities for breastfeeding support should be extended beyond the currently understood scope of their duties. The study demonstrated that PNH needed to create a breastfeeding-friendly environment that included networking with breast care support organizations and peer groups and to promote breastfeeding in public areas including the workplace.

Designing a Scale to Assess Breastfeeding Support among Public Health Nurses in Japan

Background: Promoting breastfeeding support by public health nurses (PHN) requires first that the support which they currently provide to be assessed. However, there is no assessment tool for this purpose. The aim of this study was therefore to develop a scale to assess breastfeeding support currently provided by PHN. Methods: We developed the Practice of Breastfeeding Support Scale (PBSS) for PHN based on the results of a previous study. The content validity of the PBSS was established through discussion with three other researchers. A pilot study was conducted to confirm face validity. To confirm reliability and validity, an anonymous, self-reported questionnaire was sent to PHN working in municipal offices. The statistical analyses included the Kaiser-Meyer-Olkin (KMO), Barlett’s Test of Sphericity, exploratory factor analysis (EFA), Cronbach’s alpha and correlation coefficient. Results: 768 PHN participated in this study. Cronbach’s alpha of PBSS was 0.85. The KMO measure was 0.892, and Bartlett’s Test of Sphericity was p Conclusion: The reliability and validity of PBSS were confirmed. These findings suggested that the PBSS has the potential to help promote breastfeeding support by PHN by clarifying their current breastfeeding support practices and related factors.

Acute Stress Symptoms in Families of Patients Admitted to the Intensive Care Unit during the First 24 Hours Following Admission in Japan

Families of patients in the intensive care unit often experience sever stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of patients admitted to the intensive care unit (ICU). To evaluate the prevalence and factors associated with acute stress symptoms among families of patients admitted to the ICU, we carried out a cross-sectional study at a teaching and advanced treatment hospital. The mean total Impact of Event Scale-Revised (IES-R) score differed significantly between planned and unplanned ICU admissions (t = 4.03, p < 0.05), indicating a main effect of admission type (F = 18.5, p < 0.05). There was no significant main effect of relationship (F = 0.05, p = 0.82) or interaction effect of admission type and relationship (F = 0.54, p = 0.47). Multiple regression analysis indicated that admission type was significantly associated with acute stress symptoms (B = 18.09, β = 0.47, p < 0.01), and explained 22% of the variance in total IES-R score. Whether a patient had a planned or unplanned admission to the ICU influenced symptoms associated with acute stress symptoms of family members more than did getting support from nurses, being the patient’s spouse, or the severity of illness of the patient.

Associations of Mental and Behavioral Problems among Children Exposed to Intimate Partner Violence Previously and Visits with Their Fathers Who Perpetrated the Violence

Background: Intimate partner violence has long-term and negative effects on the health of mothers and children worldwide. This study aimed to identify the mental and behavioral effects of past exposure to intimate partner violence among children and examine their associations with the children’s visits with their fathers who perpetrated the intimate partner violence. Methods: A cross-sectional study of women who had been abused by their intimate partners and had one or more children aged 4 - 18 years old was conducted from March 2015 to December 2016. Questionnaires were used to collect (1) demographic data about the mothers and children, (2) information about the children’s visits with the mother’s former partner (i.e., father), and (3) psychological data using the Hospital Anxiety and Depression Scale and the Child Behavior Checklist/4 - 18. Results: The average scores and rates of internalizing, externalizing, and total problems among the children who had been exposed to intimate partner violence were: 10.8 (SD = 10.4), 26 (51.0%);9.0 (SD = 9.0), 14 (27.5%);and 26.3 (SD = 21.5), 15 (29.4%), respectively. Children’s visits with fathers who were IPV perpetrators were significantly associated with the internalizing (AOR = 12.6, β = 0.56;p β = 0.48;p Conclusion: Attention should focus on traumatized children exposed to intimate partner violence, and thorough and cautious assessments and decisions regarding visits with their fathers who are IPV perpetrators are essential to safeguard and improve their mental and behavioral health.

The Development and Implementation of the Maternal Mental Health Promotion Program for Expectant Mothers

Approximately 19% of women have minor or major depression in the first three months following delivery. The Maternal Mental Health Promotion Program is an intervention program designed to deliver during pregnancy to increase awareness and limits the effects of postpartum depression (PPD). The program was developed through a literature review and a focus group interview. It has three components (information on depressive symptoms during postpartum, reflecting on pregnancy, and the importance of good communication with one’s partner), delivered through lectures and group discussions using educational worksheets. The purpose of this paper was to describe the development, planning and implementing of an intervention program for expectant mothers to increase awareness and limits the effects of PPD. The program was evaluated by experienced midwives, and then delivered in antenatal classes where process evaluations were conducted. We confirmed that the objectives of the program were met and that the intervention was relevant to participants.

Parents’ Perceptions and Judgment Formation Process of Their Infants’ Quality of Life

Purpose: We explored parents’ perceptions and judgment formation processes concerning their infants’ health-related quality of life (HRQOL). Method: The PedsQLTM Infant Scales—an instrument specifically designed for infants aged 1 - 24 months—were translated into Japanese. Forward and backward translations were performed, evaluating the semantic and conceptual equivalencies. Parents with infants younger than two-years-old were recruited and interviewed using think-aloud and probing techniques. Participants completed the questionnaire while speaking aloud about what came to their mind, what they thought each question meant, and how they reached each answer. Results: Seven mothers and three fathers participated. The median age was 33.4 (28 - 43) years. Four had infants younger than six-months-old. All infants were healthy. Parents’ perceptions of their infants’ HRQOL varied across their ages. Some parents with infants younger than six months experienced difficulty discussing “emotional functioning” and “cognitive functioning” because their infants were too young to articulate the actions mentioned in the items. In those cases, the parents responded, “never a problem”. Seventy-five percent of parents recalled their infants’ daily “physical functioning”, while only 58% recalled “physical symptoms”. Some parents’ perceptions and judgment formation were compromised by their own perceptions. For example, they answered “often a problem” when the items were problematic to themselves instead of to their child. However, many distinguished their infants’ HRQOL from their own perceptions, indicating they understood the intention of the questionnaire. Conclusion: Parents’ formed judgement may compromise by their own perceptions. The result of this study will be helpful in improving healthcare communication and interpreting parents’ judgments of their infants’ HRQOL in future studies.

Empirical Study on the Empowerment of Families Raising Children with Severe Motor and Intellectual Disabilities in Japan: The Association with Positive Feelings towards Child Rearing

Background: “Children with severe motor and intellectual disabilities” refers to children with markedly limited activity due to severe overlapping of physical and intellectual disabilities. The physical and mental burden placed on families raising severely disabled children, particularly the primary caregivers, is great in home settings. For families to effectively utilize services and over-come child rearing problems, the families themselves need the “strength” to cooperate with others for the purpose of raising a severely disabled child. The ultimate goal of family support is to enable such families to achieve satisfaction and self-growth in child rearing. Methods: We used a questionnaire to survey 75 primary caregivers to empirically elucidate the empowerment and positive feelings towards child rearing of families raising children with severe motor and intellectual disabilities and the related factors. The t-test and Spearman’s rank correlation coefficient were used to examine the association with bivariates. A multiple regression analysis was conducted for empowerment and positive feelings. Results: Results revealed that life events, livelihood, awareness of social support and the child’s sleep problems were factors related to empowerment. Of these, awareness of social support from outside of the family was found to contribute the most to empowerment. Furthermore, improvement and maintenance of positive feelings towards child rearing reaffirmed the existence of empowerment in addition to reducing negative feelings towards child rearing and ensuring social support. Conclusions: Raising children with severe motor and intellectual disabilities requires specialist knowledge and skills. Support from professionals to empower the entire family is therefore important in order to strengthen positive feelings towards child rearing.

The Inter Relationship of Mental State between Antepartum and Postpartum Assessed by Depression and Bonding Scales in Mothers

The number of deaths caused by child abuse is increasing, which is one of social concerns. The mental health of mothers might be related to child abuse. The aim of this study was to examine and compare the mental state of mothers in both the antepartum and postpartum period assessed by the Edinburgh Postnatal Depression Scale (EPDS) and Mother-Infant-Bonding-Scale (MIBS), and compare the results. Participants (n = 134) were recruited twice in antepartum medical checkups (20 to 36 weeks of gestation) and postpartum medical checkups (1 month after birth). Information on characteristics of participants was collected from medical records in both periods. Family function and ante-postpartum mental health were assessed by Family APGAR, EPDS, and MIBS. Antepartum depressive state was related to postpartum depressive state (p = 0.015), antepartum bonding was related to bonding in postpartum bonding (p = 0.0001), and antepartum bonding disorder was related to postpartum depressive state (relative risk = 11.7). Worries about costs and poor of family function were related to the mental health of mothers in both the antepartum and postpartum periods. Antepartum depressive state is an indicator of postpartum depression. We suggested that health professionals conduct an evaluation of mother’s mental health and related factors in the antepartum period. The present findings emphasize the importance of antepartum mental health as a predictor of postpartum depression and bonding disorder.

Prevalence of underweight and overweight among school-aged children and it's association with children's sociodemographic and lifestyle in Indonesia

Objectives:Underweight remains a health problem among Indonesian children,and the incidence of overweight continuously increases.This study aims to determine factors associated with underweight and overweight in school-aged children in Indonesia.Methods:This study is a cross-sectional investigation on parents and children aged 6e13 years in elementary schools in Makassar,Indonesia.The participants included 877 children and their parents.Anthropometric data were obtained using standardized equipment,and sociodemographic and lifestyle data were determined using a questionnaire.The nutritional status of the children was assessed based on the child growth standard prescribed by the WHO.Results:The prevalence rates of underweight and overweight among the children were 14.5%and 20.4%,respectively.Underweight was more prevalent in boys.Factors such as mother's level of education,having an underweight father,and playing outdoors on weekends for more than 2 h were significantly associated with underweight children.By contrast,mothers with high levels of education,overweight parents,sleeping for less than 9 h,and playing outdoors on weekends for less than 1 h were significantly associated with overweight children.

Knowledge and Perceived Barriers towards Intermittent Prevention of Malaria in Pregnancy: A Cross-Sectional Study

Background: Intermittent prevention of malaria is a key strategy adopted globally to ensure the wellbeing of pregnant women. By extension, these strategies enhance the healthy development of the fetus. This study assesses the knowledge and practices of pregnant women towards intermittent malaria prevention strategies in the Juaben Government Hospital of Ghana. Methods: A cross-sectional, quantitative, descriptive survey was conducted among 120 pregnant women at the antenatal clinic of the Juaben Government hospital in the Ashanti region of Ghana using a simple random sampling technique in selecting the study participants. The participant response rate was 94.5%. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Majority (54.2%) of respondents were between 20 - 29 years of age. Majority of study respondents attended Antenatal visits in their first trimester of pregnancy. Majority (69.2%) have knowledge of malaria preventive strategies in pregnancy, with about 70% of respondents stating these strategies were designed only for pregnant women. Only 37.5% of study respondents could rightly identify the chemoprophylaxis indicated for malaria prevention in pregnancy. Whereas majority (93.3%) of respondents owned insecticide-treated mosquito nets, only 63.3% utilized these nets for their purpose. Barriers to utilization of insecticide-treated nets include difficulty in setting up the nets (26.7%), using mosquito coils (10.8%), and feeling uncomfortable sleeping in the nets (36.7%). Barriers to taking malaria prophylaxis include distance to health facilities (28.3%), thoughts of not being sick with malaria (55.8%), using herbs (10.0%), and not being aware of the essence of prophylaxis (7.5%). Conclusion: Knowledge of malaria preventive strategies in pregnancy is high. However, utilization of these strategies is low due to perceived human and institutional barriers. A comprehensive community-wide approach is required to improve the utilization of these services among pregnant women.

Parent’s Perceived Provision of Information Regarding Diagnosis to Children with Brain Tumors

Background: The aim of this study was to clarify the degree of information provision to children with brain tumors, factors influencing this provision, and the relationship between this provision and psychosocial consequences. Methods: A total of 157 parents completed a questionnaire on the degree of information provision to their children and sociodemographic and medical characteristics. Parents and their children completed subscales of the Pediatric Quality of Life Inventory (PedsQL) Cancer Module. Relevant factors were investigated using ordinal logistic regression analysis and compared with PedsQL scores by degree of information provision with adjustment for age. Results: The majority of children aged 2 - 4 years received a low level of information only in regard to medical procedure and preparation. The majority of children aged 5 - 11 years were provided information regarding disease symptoms and treatment, but not actual diagnosis. Approximately half of children aged 12 - 18 years were provided detailed information including their actual diagnosis. Older children generally received more information regarding their disease (odds ratio [OR] = 1.3 per 1 year old, P < 0.001), while children with intellectual disability received less (OR = 0.2, P = 0.006). The provision of information did not worsen scores for Procedural Anxiety, Treatment Anxiety, Worry, or Communication. Conclusions: To our knowledge, this is the first report on the degree of information provision to children with brain tumors. Parents of children with brain tumors in Japan provide information dependent on age and intellectual level. The disclosure of information to children regarding their disease might affect their trust of medical and health care professionals.