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Imamura T, Sudo T, Orihashi Y, Takahashi Y, Onishi Y, Onizuka M, Mikami K, Ueda Y, Yamamoto K. Psychosocial factors predicting symptoms of depression and anxiety in allogeneic hematopoietic stem cell transplant recipients in Japan. Int J Psychiatry Med 2024; 59:287-302. [PMID: 37507109 DOI: 10.1177/00912174231191672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
OBJECTIVE We explored whether a patient's psychosocial background before allogeneic hematopoietic stem cell transplantation (allo-HSCT) could predict the occurrence of psychiatric symptoms during treatment and after hospital discharge. METHOD Logistic regression analysis was performed using INTERMED, a scale that comprehensively evaluates psychological factors such as psychiatric history, current mental status, and coping skills, and social factors such as social participation status, relationships with others, and living environment, which were used as independent variables. The Center for Epidemiologic Studies Depression Scale was used to measure depression, while the Profile of Mood States was used to measure anxiety and other symptoms. Both measures were used as dependent variables and were administered upon clean room admission, during clean room stay, at clean room discharge, and at 3, 6, and 12 months after hospital discharge. RESULTS Participants included 70 patients (45 males and 25 females, mean age 53.3 ± 12.3 years). Thirty-eight patients participated in the program for the entire period, up to 12 months after hospital discharge. The total score on the Japanese version of the INTERMED and psychological factor scores assessed at baseline were significant predictors of depressed mood on discharge; however, there were no significant predictors of scores on the Profile of Mood States. CONCLUSIONS A comprehensive pretransplant evaluation of psychosocial background can help predict the appearance of psychiatric symptoms after allo-HSCT. In patients who are expected to develop psychiatric symptoms after allo-HSCT, it is important to consider early intervention by a specialist and close monitoring by a medical team.
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Affiliation(s)
- Takashi Imamura
- Department of Clinical Psychology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takeshi Sudo
- Student Services Center, Musashi University, Nerima-ku, Japan
- Department of Psychiatry, Tokai University School of Medicine, Isehara, Japan
| | - Yasushi Orihashi
- Division of Clinical Research Center in Hiroshima, Hiroshima University Hospital, Minami-ku, Japan
| | - Yuki Takahashi
- Department of Palliative Care, Tokai University School of Medicine, Isehara, Japan
| | - Yuichi Onishi
- Department of Psychiatry, Tokai University School of Medicine, Isehara, Japan
| | - Makoto Onizuka
- Department of Hematology, Tokai University School of Medicine, Isehara, Japan
| | - Katsunaka Mikami
- Department of Psychiatry, Tokai University School of Medicine, Isehara, Japan
| | - Yasunori Ueda
- Department of Hematology/Oncology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Kenji Yamamoto
- Department of Psychiatry, Tokai University School of Medicine, Isehara, Japan
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Fiore G, Ferrari S, Cutino A, Giorgino C, Valeo L, Galeazzi GM, Marchi M. Delirium in COVID-19 and post-liver transplant patients: an observational study. Int J Psychiatry Clin Pract 2022; 26:343-351. [PMID: 35061952 DOI: 10.1080/13651501.2022.2026403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Delirium is a major complication in hospitalised patients. This study aimed to compare the mortality trends of patients with delirium according to the underlying physical condition. METHODS Hospitalised patients diagnosed with delirium by the Modena Consultation-Liaison Psychiatry Service (Italy) during 2020 were enrolled. Three groups were identified: COVID; after orthotopic liver transplant (OLT); other conditions. The full medical records were screened to retrieve socio-demographic and clinical data. INTERMED score and Delirium Rating Scale were used to retrospectively rate bio-social-complexity and delirium severity. Early (20 days) and end of study (31st January 2021) mortality were ascertained for each subject. RESULTS A total of 103 patients were enrolled. Patients hospitalised for COVID showed higher INTERMED scores (two-tailed t-test, p = 0.019) and higher 20-day mortality (HR = 3.68, p = 0.014). When considering a 1-year follow-up, the main predictor of mortality was patients' age in all three subgroups (HR = 1.06; p = 0.003). CONCLUSION Our results suggest that patients hospitalised for COVID-19 with delirium showed higher bio-psycho-social complexity and higher short-term mortality, regardless of the severity of delirium. OLT patients showed lower mortality and bio-psycho-social complexity, despite being still considered as 'complex', according to the INTERMED score. Future research should focus on understanding the underlying mechanisms in the relationship between delirium and mortality.Key pointsPatients hospitalised for COVID-19 with delirium were found at risk of higher short-term mortality and higher bio-psycho-social complexity.OLT patients showed lower overall mortality and lower bio-psycho-social complexity than the other two groups, despite being still in the 'complex' range according to the INTERMED score.Future research should assess the areas of impact of delirium in patients affected by COVID-19, considering short- and long-term outcomes.
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Affiliation(s)
- Gianluca Fiore
- School of Specialization in Psychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Ferrari
- School of Specialization in Psychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Section of Clinical Neurosciences, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Dipartimento di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Anna Cutino
- School of Specialization in Psychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Giorgino
- School of Specialization in Psychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Valeo
- School of Specialization in Psychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gian M Galeazzi
- School of Specialization in Psychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Section of Clinical Neurosciences, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Dipartimento di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mattia Marchi
- School of Specialization in Psychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Yokokawa D, Shikino K, Kishi Y, Ikusaka M. Translation and Cross-Cultural Adaptation of the Japanese Version of the INTERMED Self-Assessment Questionnaire (IMSA) for Patient-Case Complexity Assessment. Int J Gen Med 2022; 15:6309-6313. [PMID: 35924175 PMCID: PMC9342889 DOI: 10.2147/ijgm.s369056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Daiki Yokokawa
- Department of General Medicine, Chiba University Hospital, Chiba, Japan
- Correspondence: Daiki Yokokawa, Department of General Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan, Tel/Fax +81-43-224-4758, Email
| | - Kiyoshi Shikino
- Department of General Medicine, Chiba University Hospital, Chiba, Japan
| | - Yasuhiro Kishi
- Department of Psychiatry, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Masatomi Ikusaka
- Department of General Medicine, Chiba University Hospital, Chiba, Japan
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Kishi Y, Takumi I, Yamamoto H, Ishimaru T, Thurber S. Patient complexity, depression, and quality of life in patients with epilepsy at an epilepsy center in Japan. Epilepsia Open 2022; 7:414-421. [PMID: 35603460 PMCID: PMC9436305 DOI: 10.1002/epi4.12614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/19/2022] [Indexed: 12/04/2022] Open
Abstract
Objective The relationship between care complexity and quality of life among patients with epilepsy has not been assessed, especially in Japan. The aim of this study is to test the hypothesis that care complexity is associated with health‐related quality of life (HRQOL) and mood disturbance. Method This was an observational cross‐sectional study. The study included a consecutive series of 49 patients who newly visited an epilepsy center. Study participants were administered standardized quantitative measures of HRQOL, case complexity, and depression. Results Patient complexity predicted lower HRQL scores. Data on the social and psychological complexity domains predicted patient HRQOL findings more accurately than data from the biological domain of the case complexity scale. Seizure frequency was unrelated to HRQOL findings in this study. Additionally, depression scores were also associated with lower HRQOL. Significance A patient complexity assessment, including psychological and social domains, may be one of the key tools in epilepsy treatment settings. Further studies using larger random selection from patients with epilepsy are necessary to generalize the findings to patients in other epilepsy programs.
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Affiliation(s)
- Yasuiro Kishi
- Department of Psychiatry Nippon Medical School Musashikosugi Hospital Japan
| | - Ichiro Takumi
- Department of Neurosurgery, St. Marianna University Japan
- Epilepsy Center, St. Marianna University Japan
| | - Hitoshi Yamamoto
- Department of Pediatrics, St. Marianna University Japan
- Epilepsy Center, St. Marianna University Japan
| | | | - Steven Thurber
- Department of Psychiatry and Behavioral Sciences University of Minnesota USA
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Mutai R, Sugiyama Y, Yoshida S, Horiguchi R, Watanabe T, Kaneko M, Tominaga T, Hayashi D, Matsushima M. Development and validation of a Japanese version of the Patient Centred Assessment Method and its user guide: a cross-sectional study. BMJ Open 2020; 10:e037282. [PMID: 33234616 PMCID: PMC7689105 DOI: 10.1136/bmjopen-2020-037282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to develop the Japanese version of the Patient Centred Assessment Method (PCAM) and its user guide. The secondary objective was to examine the validity and reliability in the primary care setting. DESIGN Cross-sectional study. SETTING Three family physician teaching clinics located in urban residential areas in Tokyo, Japan. PARTICIPANTS Patients who were aged 20 years or older, and who had an appointment with physicians at the three participating clinics. MAIN OUTCOME MEASURES Patient complexity measured by PCAM and complexity/burden level measured by a Visual Analogue Scale (VAS). RESULTS Although confirmatory factor analysis using a model described in a previous study revealed that the indices did not meet the criteria for good fit, exploratory factor analysis revealed a new three-factor structure of 'Personal well-being,' 'Social interaction' and 'Needs for care/service.' Cronbach's alpha of PCAM was 0.86. Spearman's rank correlation coefficients between PCAM scores and VAS scores were 0.51 for complexity (p<0.001) and 0.41 for burden (p<0.001). There were 42 patients (14.3% of total patients) with PCAM scores greater than its mean of 16.5 but with complexity VAS scores less than its mean of 20.8. CONCLUSIONS The Japanese version of PCAM and its user guide were developed through Japanese translation and cultural adaptation by cognitive debriefing. PCAM is a valid and reliable tool to assess patient complexity in the primary care settings in Japan. Additionally, although the correlation between total PCAM scores and complexity/burden as assessed by VAS was moderate, PCAM can more precisely identify patient complexity than skilled physician's intuition.
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Affiliation(s)
- Rieko Mutai
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
- Department of Adult Nursing, The Jikei University School of Nursing, Chofu, Japan
| | - Yoshifumi Sugiyama
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
| | - Shuhei Yoshida
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Kitaadachi-seikyo Clinic, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Department of Community-Based Medical System, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryoko Horiguchi
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
| | - Takamasa Watanabe
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Kitaadachi-seikyo Clinic, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Makoto Kaneko
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Musashikoganei Clinic, Japanese Health and Welfare Co-operative Federation, Koganei, Japan
- Department of Family and Community Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomokazu Tominaga
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Musashikoganei Clinic, Japanese Health and Welfare Co-operative Federation, Koganei, Japan
- Koganei Family Clinic, Koganei, Japan
| | - Daichi Hayashi
- Department of Radiology, Stony Brook Medicine, Stony Brook, New York, USA
| | - Masato Matsushima
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
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Silva HSD, Gutierrez BAO. Care complexity in hospitalized elderly according to cognitive performance. Rev Bras Enferm 2019; 72:134-139. [PMID: 31826202 DOI: 10.1590/0034-7167-2018-0357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/21/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to investigate possible differences in care complexity, functional performance and biopsychosocial and health system aspects among hospitalized elderly with or without cognitive decline. METHOD quantitative, cross-sectional and analytical study in which was used the INTERMED method and cognitive and functional screening scales. We investigated 384 elderly patients admitted to a medical and surgical clinic of a University Hospital located in São Paulo/SP. RESULTS cognitive decline was present in 40.1% of the sample, most of them were longer-lived elderly individuals with less schooling and income, more dependent in activities of daily living and had greater vulnerability in different domains of INTERMED. After adjustments, the elderly with cognitive decline presented greater vulnerability in the psychological domain. CONCLUSION the relationship between cognitive decline and psychological vulnerability highlights the need to adopt long-term care based on involvement of the family, health team and different services, thereby maximizing the quality of care.
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Yoshida S, Matsushima M, Wakabayashi H, Mutai R, Murayama S, Hayashi T, Ichikawa H, Nakano Y, Watanabe T, Fujinuma Y. Validity and reliability of the Patient Centred Assessment Method for patient complexity and relationship with hospital length of stay: a prospective cohort study. BMJ Open 2017; 7:e016175. [PMID: 28490567 PMCID: PMC5623372 DOI: 10.1136/bmjopen-2017-016175] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Several instruments for evaluating patient complexity have been developed from a biopsychosocial perspective. Although relationships between the results obtained by these instruments and the length of stay in hospital have been examined, many instruments are complicated and not easy to use. The Patient Centred Assessment Method (PCAM) is a candidate for practical use. This study aimed to test the validity and reliability of the PCAM and examine the correlations between length of hospital stay and PCAM scores in a regional secondary care hospital in Japan. DESIGN Prospective cohort study. PARTICIPANTS AND SETTING Two hundred and one patients admitted to Ouji Coop Hospital between July 2014 and September 2014. MAIN PREDICTOR PCAM total score in initial phase of hospital admission. MAIN OUTCOME Length of stay in hospital. RESULTS Among 201 patients (Female/Male=98/103) with mean (SD) age of 77.4±11.9 years, the mean PCAM score was 25±7.3 and mean (SD) length of stay in hospital (LOS) 34.1±40.9 days. Using exploratory factor analysis to examine construct validity, PCAM evidently has a two-factor structure, comprising medicine-oriented and patient-oriented complexity. The Spearman rank correlation coefficient for evaluating criterion-based validity between PCAM and INTERMED was 0.90. For reliability, Cronbach's alpha was 0.85. According to negative binomial regression analyses, PCAM scores are a statistically significant predictor (p<0.001) of LOS after adjusting for age, gender, Mini Nutritional Assessment Short-Form, Charlson Comorbidity Index, serum sodium concentration, total number of medications and whether public assistance was required. In another model, each factor in PCAM was independently correlated with length of stay in hospital after adjustment (medicine-oriented complexity: p=0.001, patient-oriented complexity: p=0.014). CONCLUSION PCAM is a reliable and valid measurement of patient complexity and PCAM scores have a significant correlation with hospital length of stay.
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Affiliation(s)
- Shuhei Yoshida
- Kitaadachi-seikyo Clinic, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Masato Matsushima
- Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama, Japan
| | - Rieko Mutai
- Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
| | - Shinichi Murayama
- Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
- Shioiri-seikyo clinic, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Tetsuro Hayashi
- Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
- National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Hiroko Ichikawa
- Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
- Tokyo Rinkai Byoin, Edogawa-ku, Tokyo, Japan
| | - Yuko Nakano
- Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
- Japan Small Animal Cancer Center, Saitama, Japan
| | - Takamasa Watanabe
- Kitaadachi-seikyo Clinic, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Yasuki Fujinuma
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Seikyo-ukima clinic, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
- Interprofessional Education Research Center (IPERC), Graduate School of Nursing, Chiba University, Chiba, Japan
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Wild B, Lechner S, Herzog W, Maatouk I, Wesche D, Raum E, Müller H, Brenner H, Slaets J, Huyse F, Söllner W. Reliable integrative assessment of health care needs in elderly persons: the INTERMED for the Elderly (IM-E). J Psychosom Res 2011; 70:169-78. [PMID: 21262420 DOI: 10.1016/j.jpsychores.2010.09.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 09/10/2010] [Accepted: 09/20/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE With the increasing prevalence of multiple conditions in older age, the high prevalence of mental disorders, and the many social challenges facing elderly people, a high-risk patient group in need of interdisciplinary (biological, psychological, and social) care is emerging. The INTERMED interview is an integrative assessment method that identifies patients with complex health care needs. The aim of this study was to develop and evaluate the INTERMED for the Elderly (IM-E), specifically for use in populations of elderly persons. METHODS In focus groups conducted with the authors of the original INTERMED, the variables and anchor points that had to be adjusted to the needs and situation of the elderly and to the demands of a population-based study were discussed and altered. The final version of the IM-E was conducted with 42 elderly persons. Participants were doubly scored by two trained raters; the interrater reliability [intraclass correlation coefficient (ICC) (2,1)] was calculated. RESULTS The IM-E was well accepted by the elderly persons interviewed. ICCs for the various domains of the IM-E ranged between .87 and .95, while the ICC for the sum score was .95. Regarding the cutoff point of 20/21 for patients with complex health care needs, a κ of .75 was achieved. CONCLUSIONS The IM-E is a reliable integrative assessment instrument. It is well suited for epidemiological settings to adequately describe the percentage of elderly patients with complex health care needs. In clinical settings, it can be used to identify elderly patients in need of interdisciplinary care.
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Affiliation(s)
- Beate Wild
- Department of General Internal Medicine and Psychosomatics, University Hospital of Heidelberg, Heidelberg, Germany.
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