The perspective of psychosomatic medicine on the effect of religion on the mind-body relationship in Japan

O “Modelo Japonês” (San Mitsu) no combate à Covid 19: e os migrantes?

Resumo: Este artigo discute os paradoxos e limites do “modelo japonês” no combate ao coronavírus. Tal modelo endossou o mito de “homogeneidade racial e cultural”, ao mesmo tempo em que excluiu as necessidades dos migrantes residentes no país. Neste contexto, mostramos o mito como um ideal político dissonante com o recente cenário de migração na sociedade japonesa. Em seguida, a partir de um estudo etnográfico, analisaremos a situação dos migrantes brasileiros que residem no Japão no atual contexto da pandemia.

Disaster response among hospital nurses dispatched to evacuation centers after the Great East Japan Earthquake: a thematic analysis

Background

Disaster relief operations involve a variety of components of healthcare efforts. The post-disaster recovery is a key component of hospital preparedness. This study aimed to investigate the role of hospital nurses in the disaster area and their challenges during the relief efforts after the Great East Japan Earthquake in 2011.

Methods

Semi-structured interviews were conducted with ten nurses who worked in a general public hospital before the Great East Japan Earthquake and were dispatched to the evacuation centers after the disaster. A qualitative approach with the thematic analysis method was employed. Three research queries (RQs) were prepared before the interview.

Results

The study participants played administrative roles as city employees in addition to performing nursing services as healthcare providers in evacuation centers. The first RQ on their challenges in evacuation centers gave us four themes: criticism by the evacuees, conflicts between multiple roles, difficulties in performing the first experience, and anxiety in working. The second RQ asking about motivation to accomplish disaster relief efforts raised three themes of carrying out the nursing role, acceptance by evacuees, and strengths of human connections. Two themes of awareness of disaster medicine and professional growth were raised from the third RQ of gains from the experiences in the evacuation centers.

Conclusions

The hospital nurses in the disaster area performed multiple roles in the relief efforts in the evacuation centers, which developed a psychological burden on them. A sense of competence supported the motivation to accomplish the disaster relief activities and professional growth as a specialist in disaster medicine. A study limitation is missing hospital nurses who resigned during the relief efforts. Further study is warranted to refine the disaster preparedness of hospital operations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08231-8.

Somatic Symptoms: Association Among Affective State, Subjective Body Perception, and Spiritual Belief in Japan and Indonesia

This study aimed to examine differences in the following somatic symptoms: affective state (i.e., health concerns, anxiety, and positive and negative affect), somatosensory amplification, spirituality in Japan and Indonesia, and associations among all variables from each culture. Previous studies and a potential bio-psycho-spiritual model has identified the association of each variable in the development of somatic symptoms. Moreover, they demonstrated that individuals who describe themselves as more religious and spiritual report better physical and mental health. A total of 469 and 437 university students from Japan and Indonesia, respectively, completed the questionnaires for assessing somatic symptoms, health concerns, trait anxiety, positive and negative affect, somatosensory amplification, and spiritual belief. This study found significant differences in health concerns, positive and negative affect, state anxiety, and spiritual belief. Moreover, the difference in somatosensory amplification was negligible. There is a shared association in both cultures among somatic symptoms, affective state, subjective body perception, and spirituality. Health concerns and trait anxiety moderated somatosensory amplification in the development of somatic symptoms. However, the role of spirituality belief in somatic symptoms was observed in the Japanese and Indonesian cultures in relation to positive affect.

Religious or spiritual coping, religious service attendance, and type 2 diabetes: A prospective study of women in the United States

PURPOSE

To investigate religion and spirituality (R/S) as psychosocial factors in type 2 diabetes risk.

METHODS

Using the Nurses' Health Study II, we conducted a 14-year prospective analysis of 46,713 women with self-reported use of religion or spiritual beliefs to cope with stressful situations, and 42,825 women with self-reported religious service attendance, with respect to type 2 diabetes. Cox regression was used to assess the associations.

RESULTS

Compared with not using religious or spiritual coping at all, the fully-adjusted hazard ratios (HR) were minimally different across all categories: a little bit (HR=1.01; 95% CI:0.85, 1.19), a medium amount (HR=0.96; 95% CI:0.80, 1.14), a lot (HR=0.93; 95% CI: 0.77, 1.11) (P_trend=0.24). Similarly, compared with participants who never or almost never attend religious meetings or services, there were minimal differences with participants attending less than once/month (HR=1.06; 95% CI:0.92, 1.22), 1-3 times/month (HR=1.00; 95% CI:0.85, 1.17), once/week (HR=0.98; 95% CI:0.85, 1.14), more than once/week (HR=1.20; 95% CI:1.01, 1.43) (P_trend=0.29). Perceived stress did not modify these associations. Our hypothesis of mediated effects through lifestyle factors and social integration was not supported.

CONCLUSIONS

R/S was not significantly associated with type 2 diabetes, but its role in other chronic conditions may be important.

Exploring the Relationship Between Mental Well-Being, Exercise Routines, and the Intake of Image and Performance Enhancing Drugs During the Coronavirus Disease 2019 Pandemic: A Comparison Across Sport Disciplines

Introduction: Physical distancing under the coronavirus disease 2019 (COVID-19) pandemic had a significant impact on lifestyles, including exercise routines. In this study, we examined the relationship between mental health and addictive behaviors, such as excessive exercise and the use of image and performance enhancing drugs (IPEDs) across 12 sport disciplines. Materials and methods: A large cross-sectional sample of the adult population (N = 2,295) was surveyed. The mean age was 33.09 (SD = 11.40). The number of male participants was 668 (30.0%). The use of IPEDs was assessed in conjunction with psychometric measures such as the Exercise Addiction Inventory (EAI) and the Appearance Anxiety Inventory (AAI). The participants were grouped into activity group (AG) and non-activity group (NAG) according to the presence or absence of their exercise habits. The results were compared between these groups, as well as across sport disciplines, while taking into account the relationship between different psychological measures and IPEDs consumption. Results: The frequency of IPEDs use was higher among AG (34.6%) than NAG (14.6%), although AG participants reported less history of addictions (7.1%) than NAG (11.8%). The logistic regression analysis revealed that scores equal to or above cutoff points, in both the EAI and AAI, predicted the IPEDs use. Regarding the differences across the various sport disciplines, those who were involved in practicing Weight Lifting and Cross Fit were found to be more at risk of excessive exercising and more inclined to use a wide range of IPEDs. Conclusions: Although exercise could help to increase well-being and prevent addictions during the COVID-19 pandemic, our results show that those in the AG are particularly vulnerable to excessive IPEDs use. Sport disciplines associated with higher EAI and AAI scores have also shown a higher tendency to excessive IPEDs use. Furthermore, the factor of having above the cutoff scores in EAI or AAI in each sport could indicate larger IPEDs consumption regardless of the discipline. In light of the current findings, it is necessary to better define the "non-excessive" levels of exercise in various sport disciplines and an adequate intake of IPEDs to ensure the safety and well-being of people during a pandemic.

Martial Arts "Kendo" and the Motivation Network During Attention Processing: An fMRI Study

Japanese martial arts, Budo, have been reported to improve cognitive function, especially attention. However, the underlying neural mechanisms of the effect of Budo on attention processing has not yet been investigated. Kendo, a type of fencing using bamboo swords, is one of the most popular forms of Budo worldwide. We investigated the difference in functional connectivity (FC) between Kendo players (KPs) and non-KPs (NKPs) during an attention-related auditory oddball paradigm and during rest. The analyses focused on the brain network related to “motivation.” Resting-state functional magnetic resonance imaging (rs-fMRI) and task-based fMRI using the oddball paradigm were performed in healthy male volunteers (14 KPs and 11 NKPs). Group differences in FC were tested using CONN-software within the motivation network, which consisted of 22 brain regions defined by a previous response-conflict task-based fMRI study with a reward cue. Daily general physical activities were assessed using the International Physical Activity Questionnaire (IPAQ). We also investigated the impact of major confounders, namely, smoking habits, alcohol consumption, IPAQ score, body mass index (BMI), and reaction time (RT) in the oddball paradigm. Resting-state fMRI revealed that KPs had a significantly lower FC than NKPs between the right nucleus accumbens and right frontal eye field (FEF) within the motivation network. Conversely, KPs exhibited a significantly higher FC than NKPs between the left intraparietal sulcus (IPS) and the left precentral gyrus (PCG) within the network during the auditory oddball paradigm [statistical thresholds, False Discovery Rate (FDR) < 0.05]. These results remained significant after controlling for major covariates. Our results suggest that attenuated motivation network integrity at rest together with enhanced motivation network integrity during attentional demands might underlie the instantaneous concentration abilities of KPs.

Caring for Clients and Families With Anxiety: Home Care Nurses' Practice Narratives

This study elucidated Japanese home care nurses’ experiences of supporting clients and families with anxiety. We interviewed 10 registered nurses working in home care agencies and analyzed the data using grounded theory to derive categories pertaining to the nurses’ experiences of providing care. We conceptualized nurses’ approaches to caring for anxiety into three categories: First, they attempted to reach out for anxiety even when the client/family did not make it explicit; second, they tried to alter the outlook of the situation; and third, they created comfort in the lives of the client/family. The conceptualizations of nurses’ strategies to alleviate client/family anxiety may reflect Japanese/Eastern cultural characteristics in communication and their view of the person and social care system, but these conceptualizations may also inform the practice of Western nurses by increasing awareness of skills they may also have and use.

Burnout and Psychiatric Distress in Local Caregivers Two Years After the 2011 Great East Japan Earthquake and Fukushima Nuclear Radiation Disaster

The 2011 Great East Japan Earthquake precipitated a triple disaster of earthquake, tsunami and nuclear radiation disaster. To quantify the prevalence of burnout and psychiatric distress in local healthcare providers (caregivers) more than 2 years after the disaster, this study surveyed caregivers from affected areas through interviews about topics of concerns and two questionnaires: Maslach Burnout Inventory and General Health Questionnaire. Concerns listed by respondents were primarily radiation related: additional stress, concern for children, concern for local food, and sleep difficulties. We found significant number of caregivers to have signs of emotional exhaustion, low personal accomplishment, and psychological distress. Our findings suggest that local caregivers are experiencing substantial mental health burdens, which have unfortunately remained static from the year prior, even 2 years after the fact. Therefore, long term psychological support and improvement in caregiver work conditions are essential to maintain sustainable care in rebuilding disaster stricken areas.

Indigenous people's experiences at the end of life

OBJECTIVE

The primary purpose of this metasynthesis study was to explore the end-of-life experiences of Indigenous peoples by synthesizing the findings of qualitative research.

METHOD

Sandelowski and Barroso's methodology for synthesizing qualitative research was used and included (a) a comprehensive search, (b) appraising reports of qualitative studies, (c) classification of studies, and (d) synthesis of the findings. Research team members guided this process. This team was multidisciplinary and included Indigenous and non-Indigenous researchers from Canada, Australia, New Zealand, and the United States. Following a comprehensive search, 2255 studies were reviewed and assessed against five inclusion criteria: (a) studies on the experiences of Indigenous populations (all genders, 18 + years of age) at the end of life, (b) studies published in English from any country, (c) studies using qualitative and mixed-methods designs, and (d) studies published between 1993 and 2013.

RESULTS

Some 18 studies met the inclusion criteria, and their findings were synthesized. "Preparing the spirit" for transition to the next life was the overarching theme. "Preparing the spirit" occurred within the context of "where we come from." Processes involved in "preparing the spirit" were healing, connecting, and protecting; through these processes, "what I want at the end of life" was realized. Although not the focus of the metasynthesis, a significant finding was that the studies reviewed identified very clear barriers within healthcare systems and current healthcare provider practices to "preparing the spirit."

SIGNIFICANCE OF RESULTS

The findings provide a beginning understanding of the end-of-life experiences of Indigenous peoples and a foundation for future research. More interpretive qualitative research is critical if palliative care services, the healthcare system, and healthcare providers are to reduce current barriers to "preparing the spirit" for the journey at the end of life.

Age and gender differences in the factor structure of the Center for Epidemiological Studies Depression Scale among Japanese working individuals

OBJECTIVES

Depression is a serious mental illness with a high rate of prevalence. Depressive sympotomatology is heterogeneous and is expressed as a combination of emotional, physical, cognitive, and social symptoms. The objective of this study was to examine differences in the factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D) among Japanese working individuals of differing age and gender using exploratory factor analysis (EFA).

METHODS

This study examined the factor structure of the CES-D in a sample of 6696 Japanese working individuals aged 20 and older. To examine within-group differences in the structural characteristics of the CES-D, the participants were stratified by age subgroup.

RESULTS

The EFA with promax rotation identified three factors among the participants. These factors were labeled "depressed and negative complaints" (DEP), "somatic and apathetic complaints" (SOM), and "positive affect" (POS). Although the three factors were comparable for males in their 20-50s and females in their 20s and 30s, the content of these factors varied for other subgroups. For females in their 40s and 50s, items 15 and 19 (belonging to Radloff's original interpersonal problem factor) constituted an independent factor. For all individuals in their 60s, items that were not included in the SOM and POS factors constituted new factors that were not observed for participants in their 20s-50s.

CONCLUSION

These findings indicate that age and gender could affect the factor structure of the CES-D among Japanese working individuals. Psychosocial or biological factors might contribute to the age- and gender-related differences in the factor structure of the CES-D.