Factor Structure and Measurement Invariance of the Japanese Version of the Mother-to-Infant Bonding Scale

Background: Bonding disorders affect the growth and development of infants. In Japan, the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) is widely used for early detection of bonding disorders. Repeated use of a questionnaire has problems of reduced validity. In order to correctly detect bonding disorders at multiple time points, it is necessary to confirm the measurement invariance of the scale. Baba et al. reported that invariance of the MIBS-J factor structure could only be obtained by abridging the scale into three items. Purpose: The aim of this study was to 1) confirm the factor structure and measurement invariance of the MIBS-J between two measurement times and 2) to examine factors that can be used without being affected by measurement time in order to identify item that contribute to measure met invariance. Methods: We analysed the data of 1049 and 878 mothers with a neonate collected in two waves: 5 days (Wave 1) and 1 month postpartum (Wave 2). Exploratory and confirmatory factor analyses were conducted on the data randomly divided into two groups in each wave. Results: The three-item model (MIBS-J items 1, 6, and 8) was most accepted. Measurement invariance and structural invariance were confirmed in the model. This was consistent with Baba et al.’s model. Conclusion: The three MIBS-J items showed measurement invariance and structural invariance in Japanese mothers during 1 month postpartum.

Certified Infertility Nurses’ Perceptions and Practice on Male Infertility Nursing and Related Factors

Purpose: The aims of this study were to clarify the complaints and concerns expressed by couples that included a partner with male infertility, certified infertility nurses’ nursing practice and perceptions of nursing for these couples, and factors related to these perceptions and practices. Methods: A quantitative cross-sectional study was conducted. Prospective participants were sent an anonymous self-administered questionnaire containing items pertaining to the complaints and concerns expressed by couples that included a partner with male infertility, and nursing practice and perceptions of nursing for these couples. Results: In total, 133 questionnaires were distributed, 74 responses were received, and 69 of these responses were valid. Couples’ complaints and concerns consisted of a three-factor structure comprising psychological burden, lack of knowledge and information, and problems with partners. Nurses reported that the complaints and concerns of couples that included a partner with male infertility differed between male and female partners. Factors related to nursing practice and nurses’ perceptions of nursing were identified. Conclusions: Participants felt that psychological burden and problems were more serious for female partners than they were for male partners, and concern regarding the physical health of the partner receiving treatment was greater in male partners than it was in female partners.

Talking with Children about Cancer: A Content Analysis of Text in Children’s Picture Books

Introduction: To tell children that they are diagnosed with cancer is challenging for any healthcare professional and family. Pictures books are one of the communication tools for talking with children about severe diseases. However, little research is available about the contents of picture books about cancer for children. Therefore, this study aimed to examine the contents of children’s picture books about cancer and explore the advantages and disadvantages of using picture books to communicate with children about cancer. Methods: We searched the picture books about cancer written for children aged under ten years old on the Amazon.com Web site on 5 July 2019 and hand-searched on the cancer-related institutes’ Web site. We extracted the texts of relevant picture books and conducted a content analysis of them. Results: We identified 2555 picture books and included 30 of them. We identified three main contents, 1) cancer-related knowledge, 2) impacts of cancer, and 3) dealing with cancer. These contents were written with simple words and illustrations. Some of them included the essential contents, which might be misunderstood by children. Conclusions: Picture books might be helpful for children to understand about cancer. However, as these books do not include all contents, it is necessary to select and use multiple books depending on the content which is wanted to tell the child. Further research should evaluate the impacts of these books as a communication tool when talking with children diagnosed with cancer.

Preventing Pregnant Women’s Exposure to Secondhand Smoke: Development and Suitability Assessment of an Educational Comic Booklet

Aim: The aim of this mixed methods research was to develop an educational comic booklet to prevent pregnant women’s exposure to secondhand smoke. Methods: We assessed the suitability of the comic booklet by measuring participant response to content, literacy demand, graphics, layout and typography, learning stimulation, motivation, and cultural appropriateness. The participants were 17 Indonesians living in Japan who were recruited through Respondent-Driven-Sampling and met all criteria for the survey. Means and standard deviations were used to determine the suitability of the educational comic. Results: About 80% of participants rated the comic as “superior” on a rating scale with options of “superior”, “adequate”, “not suitable”, or “not applicable”. The most successful aspects of the comic were content and cultural appropriateness, as it provided clear contents and the graphics showed realistic Indonesian smoking behavior. The least successful aspect of the comic was the literacy demand because there were long sentences using difficult words. Conclusions: The results of this study may be used to conduct a randomized controlled trial using this comic booklet with some modifications.

Family empowerment and associated factors in Japanese families raising a child with severe motor and intellectual disabilities

Objectives:Family caregivers raising children with severe motor and intellectual disabilities(SMID)experience the enormous burden of care.The concept of family empowerment is one of the important assessment indexes of family nursing from the perspective of providing comprehensive support for these families.The objective of this study was to identify the factors associated with the empowerment of families raising a child with SMID in Japan.Methods:We conducted a nationwide questionnaire survey involving 1659 primary caregivers raising a child with SMID through 89 special schools.We assessed the main outcomes using the Family Empowerment Scale(FES).We then conducted a multiple linear regression analysis to reveal the factors associated with family empowerment.Results:In total,1362 primary caregivers were included in our study.Our results show that factors contributing to high FES scores are higher age of the primary caregiver,higher education,greater recognition of regional support,lower childcare burden,higher utilization of home visit services,higher usage of a childcare institution,higher household income,and stronger family bonding.Conclusion:Healthcare professionals should carefully assess the state of family empowerment of the primary caregivers who are younger and those who have low education,low household income,high childcare burden,and fragile bonding with the family.Second,they should encourage such families to use regional support resources for childcare.That is,policy makers should consider ways to promote home visits and institutional services for the care of children with SMID,aiming especially for the provision of well-coordinated care and services.

People-Centered Care: Concept Analysis

Purpose: This study aims to clarify the definition, attributes, antecedents, and consequences of the concept of people-centered care (PCC). Method: Rogers and Knafl’s evolutionary method was used to analyze the concept of People-centered care. The cords such as “Attributes,” “Antecedent,” and “Consequences” were extracted on the coding sheet. The extracted contents of each of the “Attributes,” “Antecedent,” and “Consequences” from the created coding sheets were summarized as codes, and similar codes were categorized. Result: We included 33 studies in the analysis. As a result of the analysis, we identified four attributes (the subject is people, approaches to improving and enhancing health issues, relationships as a basis for partnership building, and behavioral attitudes for building partnerships), four antecedents (changes in social conditions, increasing people’s ownership of their health, health issues in modern society, and care in a variety of settings), and three consequences (achieving goals set by the people themselves, self-transformations of both people and healthcare providers, and social transformations). Discussion: Based on the analysis results, PCC was defined as “an initiative in which people step forward and partner with health care providers to improve and enhance health issues in individuals and communities.” In various social and individual changes, the realization of PCC is expected to result in the achievement of goals set by the people themselves together with health care providers and the transformation of individuals and society.

Factors Affecting Disease Risk Perception and Self-Management Behaviors among Japanese Long-Term Overseas Volunteers

Introduction: Many overseas volunteers have worked in low and middle-income countries. However traveling abroad and staying in an unfamiliar environment with inadequate medical infrastructure exposes volunteers to a wide range of health risks. The aim of this study was to clarify the relationships among disease knowledge and symptoms, disease risk perception, and self-management skills. Methods: This was a questionnaire survey of 189 Japanese who were preparing to volunteer abroad. A factor analysis was conducted on 13 items (six general risk events and seven major diseases) of risk perception. Correlation analysis was performed between the identified risk perception factors and disease knowledge and symptoms. Risk perception scores by factors from the seven disease items were compared between the Self-management Score (SMS) group and disease knowledge and risk of symptoms group, using T-tests. St. Luke’s International University Ethics Committee (19-A092) approved this study. Results: Many participants expected to suffer from digestive diseases (69.3%) and dermatitis (55%) in the field. On the other hand, few expected high risk of malaria (26.5%) or dengue fever (36%). Factor analysis yielded robust factor loadings creating a “Dread” and an “Unknown” factor accounting for 62.2% of total variance. Strong correlation was not found between SMS and disease risk perception. A weak negative correlation was observed in dengue fever, digestive disorders, and dermatitis (r = −0.20 to −0.25, p < 0.001) on the “Unknown” factor. A high SMS score was associated with a lower “Unknown” factor score for malaria, diarrhea, dermatitis, and dental disorders. In addition, higher disease knowledge was significantly associated with higher “Dread” factor score for dental disorders. Conclusions: Self-management skills and disease knowledge will enable higher risk awareness of common diseases and high lethality diseases.