Few studies have examined the epidemiology of post-intensive care syndrome in Japan. This study investigated the mental health and quality of life of patients living at home in Japan after intensive care unit (ICU) discharge. Additionally, we examined whether unplanned admission to the ICU was associated with more severe post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms. An ambidirectional cohort study was conducted at 12 ICUs in Japan. Patients who stayed in the ICU for > 3 nights and were living at home for 1 year afterward were included. One year after ICU discharge, we retrospectively screened patients and performed a mail survey on a monthly basis, including the Impact of Event Scale—Revised (IER-S), the Hospital Anxiety Depression Scale (HADS), and the EuroQOL—5 Dimension (EQ-5D-L) questionnaires. Patients’ characteristics, delirium and coma status, drugs used, and ICU and hospital length of stay were assessed from medical records. Descriptive statistics and multilevel linear regression modeling were used to examine our hypothesis. Among 7,030 discharged patients, 854 patients were surveyed by mail. Of these, 778 patients responded (response rate = 91.1%). The data from 754 patients were analyzed. The median IES-R score was 3 (interquartile range [IQR] = 1‒9), and the prevalence of suspected PTSD was 6.0%. The median HADS anxiety score was 4.00 (IQR = 1.17‒6.00), and the prevalence of anxiety was 16.6%. The median HADS depression score was 5 (IQR = 2‒8), and the prevalence of depression was 28.1%. EQ-5D-L scores were lower in our participants than in the sex- and age-matched Japanese population. Unplanned admission was an independent risk factor for more severe PTSD, anxiety, and depressive symptoms. Approximately one-third of patients in the general ICU population experienced mental health issues one year after ICU discharge. Unplanned admission was an independent predictor for more severe PTSD symptoms.

Aim This study aimed to translate the TeamSTEPPS® Teamwork Perceptions Questionnaire (T‐TPQ) into Japanese and assess its validity and reliability. Design Translation of the T‐TPQ and a cross‐sectional survey. Methods Following a forward and back translation of the questionnaire, content validity was assessed by an expert panel using item‐level content validity index. Construct validity was assessed by a confirmatory factor analysis. Further, intraclass correlation coefficient was estimated by test–retest methods. Results A total of 587 healthcare professionals responded to the translated T‐TPQ. The item‐level content validity index ranged between 0.8 and 1.0, indicating an acceptable content validity. The multiple fit indices showed an acceptable fitting model. Fifty‐one healthcare professionals participated in the test–retest method. Intraclass correlation coefficients for all dimensions ranged from 0.838 to 0.957, indicating acceptable test–retest reliability. Our findings suggest that the Japanese version of the T‐TPQ has acceptable validity and reliability.

This study evaluates the impact of the 1990-1994 conflict in northern Mali on child health at different timings of exposure (in utero and after birth). Two anthropometric variables (height-forage and weight-for-height Z-scores) are used as indicators of child health. The empirical strategy relies on the difference-indifference approach based on birth cohort, GIS residence information, and conflict intensity. The intensity of conflict exposure is measured by the number of deaths resulting from a conflict that broke out within a 10-km radius of each community. The estimation results show that the more severe the exposure to children and their mothers, the greater is the negative impact on the height, but not on the weight, of children. Additionally, the timing of conflict exposure plays a critical role in the outcome of a child's health: exposure to conflict in utero, rather than after birth, negatively affects health. Placebo test as well as tests of selective migration, fertility, and mortality are conducted and confirmed the robustness of the main results. The differential effects of the timing of exposure in utero suggest that the heightened maternal stress is the main mechanism.