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Inokuchi R, Hanari K, Shimada K, Iwagami M, Sakamoto A, Sun Y, Mayers T, Sugiyama T, Tamiya N. Barriers to and facilitators of advance care planning implementation for medical staff after the COVID-19 pandemic: an overview of reviews. BMJ Open 2023; 13:e075969. [PMID: 37816562 PMCID: PMC10565150 DOI: 10.1136/bmjopen-2023-075969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/19/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic has impacted the capacity for advance care planning (ACP) among patients, families and healthcare teams. We sought to identify and review the barriers to and facilitators of ACP implementation for medical staff in different settings (eg, hospitals, outpatient palliative care, nursing and care homes) during the pandemic. DESIGN This study employed an overview of reviews design. We searched the MEDLINE, CENTRAL, Web of Science and Embase databases for studies published between 8 December 2019 and 30 July 2023. We used AMSTAR 2 to assess the risk of bias. RESULTS We included seven reviews. Common barriers to ACP implementation included visitation restrictions, limited resources and personnel and a lack of coordination among healthcare professionals. In care and nursing homes, barriers included a dearth of palliative care physicians and the psychological burden on facility staff. Using telemedicine for information sharing was a common facilitator across settings. In hospitals, facilitators included short-term training in palliative care and palliative care physicians joining the acute care team. In care and nursing homes, facilitators included ACP education and emotional support for staff. CONCLUSIONS Visitation restrictions and limited resources during the pandemic posed obstacles; however, the implementation of ACP was further hindered by insufficient staff education on ACP in hospitals and facilities, as well as a scarcity of information sharing at the community level. These pre-existing issues were magnified by the pandemic, drawing attention to their significance. Short-term staff training programmes and immediate information sharing could better enable ACP. PROSPERO REGISTRATION NUMBER CRD42022351362.
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Affiliation(s)
- Ryota Inokuchi
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kyoko Hanari
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Hinohara Memorial Peace House Hospital, Nakai, Kanagawa, Japan
| | - Kensuke Shimada
- Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Masao Iwagami
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ayaka Sakamoto
- Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yu Sun
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Thomas Mayers
- Medical English Communications Center, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takehiro Sugiyama
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Shinjuku-Ku, Tokyo, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Rimayanti UP, Mizuno M, Kadar K, Madjid A, Sahraeny S, Effendy C, Setiyarini S, Mayers T. Ensuring reliability and cultural validity of the Indonesian version of the Quality Of Life Index for patients with cancer. Res Nurs Health 2023; 46:527-537. [PMID: 37596709 DOI: 10.1002/nur.22334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 06/16/2023] [Accepted: 08/05/2023] [Indexed: 08/20/2023]
Abstract
The objective of this study was to translate the Ferrans and Powers Quality of Life Index (QLI) into the Indonesian language, considering its cultural and functional appropriateness, and to evaluate its psychometric properties by testing the reliability and validity. A committee approach was conducted to create the Indonesian version of the QLI (QLI-Id) and cognitive interviewing with 15 patients with cancer was conducted to identify potential problems or errors in answering the QLI-Id. A cross-sectional descriptive study was carried out using 236 responses to the QLI-Id questionnaire from patients with cancer; 62 of whom completed the same questionnaire twice within a 3-week interval to verify stability reliability. Confirmatory factor analysis results supported construct validity with model fit statistics for the original single-factor and four-factor structure of the QLI (corresponding to the QLI's total score and four subscale scores, respectively) with some rearrangement of the items within each subscale. Reliability for the total QLI-Id scale was supported by McDonald's Omega of 0.92 and the intraclass/intrasubject correlation coefficient at two time points of 0.86. The strong correlation between the QLI-Id total and the Satisfaction with Life Scale scores and the overall health/QOL domain of the EORTC QLQ-C30 (both r = 0.73) supported its construct validity. This study provides evidence for the reliability and validity of the QLI-Id as an instrument to measure the impact of cancer on the overall QOL of Indonesian patients.
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Affiliation(s)
- Ummi Pratiwi Rimayanti
- Doctoral Program in Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Michiyo Mizuno
- Health Innovation and Nursing, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kusrini Kadar
- Department of Community, Family, and Gerontological Nursing, Faculty of Nursing, Universitas Hasanuddin, Makassar, Indonesia
| | - Abdul Madjid
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Hasanuddin, Makassar, Indonesia
| | - Sitti Sahraeny
- Department of English, Faculty of Cultural Sciences, Universitas Hasanuddin, Makassar, Indonesia
| | - Christantie Effendy
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jakarta, Indonesia
| | - Sri Setiyarini
- Department of Basic and Emergency Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jakarta, Indonesia
| | - Thomas Mayers
- Health Innovation and Nursing, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
- Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
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Matsuda H, Mayers T, Maki N, Araki A, Eto S. Frailty and Diminished Human Relationships Are Associated with Poor Sleep Quality in Japanese Older Adults: A Cross-Sectional Study. Geriatrics (Basel) 2023; 8:91. [PMID: 37736891 PMCID: PMC10514848 DOI: 10.3390/geriatrics8050091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023] Open
Abstract
The purpose of this study was to examine the association between sleep quality, frailty, and human relationships in Japanese older adults (aged 65 years and above, excluding those certified as requiring long-term care). This cross-sectional study used a questionnaire survey to gather demographic information, data on frequency of conversation and conversation partners, and employed the following validated instruments: Kihon Checklist (KCL), a Japanese instrument used to determine the care needs and frailty of older adults; the Dysphagia Risk Assessment for Community-Dwelling Elderly (DRACE) scale; Japanese versions of Pittsburgh Sleep Quality Index (PSQI-J); the Geriatric Depression Scale-15 (GDS-15-J); and the University of California Los Angeles Scale (UCLA-J), an instrument to assess loneliness in older adults. The 500 respondents were divided into two groups based on sleep quality (PSQI-J): low sleep quality group (n = 167, 33.4%) and high sleep quality group (n = 333, 66.6%). Our analyses showed that the low sleep quality group had a KCL score of 5.55 ± 2.47, which indicated frailty. Binomial logistic regression analysis identified age, number of diseases under treatment, DRACE, GDS-15-J, and conversation frequency and discussion partner for important matters as factors (p < 0.05) associated with poor sleep quality. These factors could help enhance the detection of frailty and predictability of caregiving needs.
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Affiliation(s)
- Hitomi Matsuda
- Graduate School of Comprehensive Human Sciences, Department of Human Care Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
| | - Thomas Mayers
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
- Medical English Communications Center, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Naoki Maki
- Faculty of Rehabilitation, R Professional University of Rehabilitation, 2-12-31 Kawaguchi, Tsuchiura 300-0032, Ibaraki, Japan;
| | - Akihiro Araki
- Community Health Nursing Department, Oita University of Nursing and Health Sciences, 2944-9 Megusuno, Oita-City 870-1201, Oita, Japan;
| | - Sachie Eto
- Graduate School of Comprehensive Human Sciences, Department of Human Care Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
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Aonuma R, Mayers T, Mizukami K, Aonuma K, Matsuda H. Factors Associated with Volunteer Activities and Sleep Efficiency in Older Adults with Hypertension: A Sequential Model Study. Geriatrics (Basel) 2021; 6:geriatrics6030089. [PMID: 34562990 PMCID: PMC8482086 DOI: 10.3390/geriatrics6030089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/31/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to examine, using a sequential model, factors associated with volunteer participation and sleep efficiency in Japanese older adults receiving treatment for hypertensive disease. A questionnaire survey was conducted to collect data on participant demographics, lifestyle, health status, and depression, and sleep activity monitors were used to objectively measure sleep status and sleep efficacy. Of the 167 respondents, the 59 being treated for hypertension were divided into two groups based on their participation in volunteering. Comparison between the groups showed significant differences in nocturnal awakening, sleep efficiency, and nap frequency. Volunteers had less nocturnal awakening, increased sleep efficiency, fewer naps, and decreased depression. Covariance structure analysis of the survey data and sleep measurements for hypertensive older adults in the volunteer group was performed by modeling the relationships between variables with a path diagram. Our model showed strong goodness of fit (χ2 test = 15.636, p = 0.111, GFI = 0.925, AGFI = 0.842, CFI = 0.925, RMSEA = 0.099). The findings of this study suggest that older adults with hypertension who participate in volunteer activities have less nocturnal awakening, improved sleep quality, and reduced risk of depression, and provides evidence to promote social participation in volunteering among older adults with hypertension.
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Affiliation(s)
- Ryoko Aonuma
- Graduate School of Comprehensive Human Sciences, Department of Human Care Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
- Correspondence:
| | - Thomas Mayers
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
- Medical English Communications Center, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Katsuyoshi Mizukami
- Graduate School of Comprehensive Human Sciences, Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
| | - Hitomi Matsuda
- Graduate School of Comprehensive Human Sciences, Department of Human Care Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan;
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Hanari K, Sugiyama T, Inoue M, Mayers T, Tamiya N. Caregiving Experience and Other Factors Associated With Having End-Of-Life Discussions: A Cross-Sectional Study of a General Japanese Population. J Pain Symptom Manage 2021; 61:522-530.e5. [PMID: 32827656 DOI: 10.1016/j.jpainsymman.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT The factors associated with end-of-life discussion (EOLD) are not well elucidated; an understanding of these factors may help facilitate EOLD. OBJECTIVES To investigate the associations between EOLD and experiences of the death of and/or care for a loved one and other factors. METHODS Data from a nationwide anonymous questionnaire survey of public attitudes toward end-of-life medical care, conducted in December 2017 in Japan, were used. Participants were randomly selected from the general population (age ≥ 20 years), and respondents who completed the questionnaire were analyzed (respondents: n = 836; effective response rate: 13.9%). Respondents were divided into two groups based on their experience of EOLD: those who had engaged in EOLD and those who had not. The main predictors were the experiences of the death of and care for a loved one. Multivariable logistic regression analyses were performed. RESULTS Of the 836 respondents (male: 55.6%, aged 65 and over: 43.5%), 43.7% reported their engagement in EOLD. In the analyses, "having experience of caring for a loved one" was associated with EOLD compared with never having experience (odds ratio 1.88, 95% confidence interval 1.35-2.64). However, having experience of the death of a loved one had no association. CONCLUSION For health-care providers, it may be worth recognizing that the care experience of their patient's caregiver might affect the caregiver's own EOLD in the future.
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Affiliation(s)
- Kyoko Hanari
- Doctoral Programs in Medical Sciences, Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takehiro Sugiyama
- Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan; Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Megumi Inoue
- Department of Social Work, George Mason University, Fairfax, Virginia, USA
| | - Thomas Mayers
- Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Medicine, Medical English Communications Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Mizuno M, Munezawa N, Yamashita M, Sasahara T, Mayers T, Park C, Ferrans CE. Reliability and validity of the Japanese version of the Quality of Life Index for patients with cancer. Res Nurs Health 2020; 43:176-185. [PMID: 31985085 DOI: 10.1002/nur.22011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/30/2019] [Indexed: 11/09/2022]
Abstract
This study was designed to evaluate the psychometric properties of the newly completed Japanese translation of the Ferrans and Powers Quality of Life Index Cancer Version III (QLI). Using a cross-sectional descriptive design, 136 ambulatory patients with gastrointestinal cancer (55 receiving chemotherapy, 76 with stable health status after treatment, and five status not known) completed a questionnaire at a one-time point, and 26 patients (stable health status) completed the questionnaire again 2 weeks later. Internal consistency reliability was supported by Cronbach's α of .96 for the total scale, with subscales ranging from .83 to .93. A test-retest correlation of 0.76 (total scale) provided evidence of stability reliability over a 2-week period, with subscale retest correlations ranging from 0.70 to 0.83. Confirmatory factor analysis showed the same four domains for the Japanese translation as the original QLI, supporting construct validity. We also assessed construct validity by examining the relationships between the Japanese QLI and six other concepts known to be related to the quality of life. As hypothesized, all correlations were moderate and in the expected direction (pain -0.39, anxiety -0.54, depression -0.63, stress -0.51, pain interfering with functioning -0.52, and general health 0.62). This evidence of the reliability and validity of the Japanese translation of the QLI supports its use in research and clinical practice to evaluate the impact of cancer and treatment. This new translation can be used to assess the patient's perspective of their quality of life, both within Japan and in cross-cultural studies with the QLI in other languages.
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Affiliation(s)
- Michiyo Mizuno
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Noriko Munezawa
- Department of Nursing, Faculty of Health Science Technology, Bunkyo Gakuin University, Tokyo, Japan
| | | | - Tomoyo Sasahara
- School of Nursing, Tokyo Women's Medical University, Tokyo, Japan
| | - Thomas Mayers
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Chang Park
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Carol Estwing Ferrans
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Mayers T, Kashiwagi S, Mathis BJ, Kawabe M, Gallagher J, Morales Aliaga ML, Kai I, Tamiya N. International review of national-level guidelines on end-of-life care with focus on the withholding and withdrawing of artificial nutrition and hydration. Geriatr Gerontol Int 2019; 19:847-853. [PMID: 31389113 DOI: 10.1111/ggi.13741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/10/2019] [Accepted: 06/22/2019] [Indexed: 11/27/2022]
Abstract
AIM The purpose of the present study was to collate examples of end-of-life care guidelines from various counties, examine their contents, and gain an overall picture of how end-of-life care guidance is offered to physicians and care providers internationally. METHODS In this study, eight researchers worked independently to source and examine national-level end-of-life care guidelines from different countries and regions. Data collected by each researcher were gathered into a unified table. The items in the table included basic information (publisher, year, URL etc.) and more specific items, such as the presence/absence of legal information and family's role in decision-making. These data were then used to identify trends, and examine the mechanics and delivery of guidance on this topic. RESULTS A total of 54 guidelines were included in the study. All the guidelines were published between 2000 and 2016, and 60% (n = 33) were published after 2012. The length of the guidelines varied from two to 487 pages (median 38 pages), and had different target audiences - both lay and professional. A total of 38 (70%) of the guidelines included information about the relevant laws and legal issues, 47 (87%) offered advice on withholding and withdrawing treatment, 46 (85%) discussed the family's role in decision-making and 46 (85%) emphasized the teamwork aspect of care. CONCLUSIONS The present findings show that end-of-life care guidelines are generally made reactively in response to the trend toward patient-centered care, and that to create effective guidelines and implement them requires multilevel cooperation between governmental bodies, healthcare teams, and patients and their families. Geriatr Gerontol Int 2019; 19: 847-853.
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Affiliation(s)
- Thomas Mayers
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.,Medical English Communications Center, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shiho Kashiwagi
- Gender Equality Office, University of Yamanashi, Yamanashi, Japan
| | - Bryan J Mathis
- Medical English Communications Center, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Makiko Kawabe
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Joshua Gallagher
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Maria L Morales Aliaga
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Ichiro Kai
- Emeritus Professor of Social Gerontology, University of Tokyo, Tokyo, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Mizuno M, Sugimoto K, Mayers T, Ferrans CE. Ensuring Cultural and Cognitive Integrity in Instrument Translation: Quality of Life Index for Japanese Cancer Patients. Asia Pac J Oncol Nurs 2019; 6:64-71. [PMID: 30599018 PMCID: PMC6287387 DOI: 10.4103/apjon.apjon_57_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective The objective of this paper is to provide a practical illustration of methods useful for translating and testing questionnaire instruments for nursing and healthcare to ensure reliability, validity, and appropriateness for the target culture. Methods We present the process used to create the Japanese version of a well-established quality of life (QOL) instrument, originally developed in American English. The Ferrans and Powers Quality of Life Index (QLI)-Cancer Version III was translated into Japanese by a team of bilingual translators and tested using an iterative process involving cognitive interviewing with monolingual Japanese cancer patients. Results Discussions among the translation team made it possible to find and resolve linguistic, cultural, and practical issues regarding the translation. Problems stemming from question interpretation and information retrieval were resolved through the cognitive interviewing process. One problem related to response editing could not be remedied with altered phrasing, namely a question referring to the respondents' sex lives. This item was retained in the Japanese version of the QLI as an indispensable component of QOL, particularly in a healthcare context. Conclusions The final Japanese version captured the intended meaning of the original, and also was culturally appropriate and clearly understood by Japanese cancer patients.
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Affiliation(s)
- Michiyo Mizuno
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Keiko Sugimoto
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Thomas Mayers
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Carol Estwing Ferrans
- Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Johnson D, Hurst T, Mayers T. Halothane effects regional hypoxic pulmonary vasoconstriction. Can J Anaesth 1990; 37:S167. [PMID: 2361280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- D Johnson
- Department of Anaesthesia and Medicine, University of Saskatchewan, Saskatoon
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