AimsThe aim of this study was to examine the reliability and validity of the Practice Environment Scale of the Nursing Work Index (PES‐NWI) for hospital nurses in Japan.DesignA cross‐sectional mail survey.MethodsParticipants in this study were 1,219 full‐time ward nurses from 27 hospitals in Japan, using 31 items of the Japanese version of the PES‐NWI questionnaire, from December 2008‐March 2009. Construct validity, criterion‐related validity and internal consistency of the PES‐NWI were tested.ResultsThe PES‐NWI showed reliable internal consistency. The five‐factor structure was supported by confirmatory factor analysis. The PES‐NWI correlated significantly with job satisfaction, burnout and the nurses’ intention to stay on the job, supporting criterion‐related validity.

AimLittle is known about whether and how local-level resources regarding home care are associated with the prevalence of home deaths. We aimed to investigate whether geographic patterns of the resources for home care were associated with the prevalence of home deaths, taking spatial variation into consideration.MethodsWe conducted an ecological cross-sectional study in Japan using nationwide data in 2014. The areal unit was the municipality, the smallest administrative unit in Japan. We investigated the association between the percentage of home deaths and the resources of home care support clinics with available 24-hour-a-day functions, considering the geographic effect of neighboring municipalities by applying a geographically weighted regression model.ResultsThe mean and standard deviation of the percentages of home deaths were 11.4% (5.0%), and those of the number of home care support clinics per 10,000 elderly population were 3.4 (3.7). The percentages of home deaths in neighboring municipalities tended to be significantly correlated (Moran’s I 0.34, p<0.001). Adjusting for the number of hospital beds, total population, and the socio-economic status of municipality, the results of an ordinary least squares regression model showed a positive correlation between the percentage of home deaths and the local resources for home care support clinics per 10,000 elderly population (regression coefficient 0.15, 95% confidence interval 0.07, 0.22), while the existence of spatial autocorrelation of the residual was suggested (Moran’s I of the residual 0.227, p<0.001). The geographically weighted regression model showed local regression coefficients varying across municipalities with a better model fit over the analogous ordinary least squares model (adjusted R2 0.414 vs. 0.131).ConclusionHome deaths were more prevalent in municipalities with greater home care resources. This association was geographically varied and further strengthened in some areas.

BackgroundDespite societal efforts to alleviate the challenges, caregiving seems to constitute a substantial burden and source of stress for many families of older adults in Japan. However, precise information on the physical health of caregivers, based on objective data, is not available. The purpose of this study was to improve the understanding of the physical health of Japanese family caregivers using objective indicators and a comparative research design.MethodsA cross-sectional, comparative study was conducted among family caregivers and their non-caregiver counterparts. Surveyors visited caregivers in their homes to administer a questionnaire survey, measure their blood pressure, and collect blood samples using a kit. Blood samples were tested for LDL-Cholesterol, HDL-Cholesterol, AST, ALT, γ-GTP, uric acid, creatinine and HbA1c. Non-caregiver data were collected at a university-based health checkup center. We compared 149 caregivers with 149 sex- and age-matched non-caregivers using conditional logistic regression analyses to examine the impact of caregiving, adjusting for multiple control variables. Analyses were conducted separately for men and female.ResultsThe prevalence of high blood pressure was significantly higher among caregivers than non-caregivers (male: 72.7% among caregivers vs. 40.9% among non-caregivers, female: 57.1% vs. 27.6%, respectively). After adjusting for related sociodemographic and health factors, high blood pressure remained significantly more prevalent among caregivers than non-caregivers, only among female (adjusted OR=2.16, 95% CI [1.14, 4.08]). Female caregivers showed lower eGFR than their non-caregiver counterparts (adjusted OR=6.54, 95% CI [2.38, 17.91]). No significant differences were observed between the two groups on any other indicators.ConclusionsResults suggest that female caregivers are at a higher risk of conditions such as cerebral, cardiovascular or kidney diseases than non-caregivers. Steps must be taken to identify caregivers with high blood pressure and lowered eGFR and provide them with the support they need before these risk factors develop into serious diseases.

Aim: To investigate nurses' perceptions of their work environment and to investigate the relationships between variables measuring the work environment (WE) and nursing outcomes (NOs).Design: A 2-year prospective longitudinal survey (2013)(2014)(2015). Method(s):Descriptive statistics of nurse demographics, organizational WE and NOs were calculated by position. The associations between Practice Environment Scale of the Nursing Work Index (PES-NWI) and NOs were examined for each unit. Results:The participants were 2,992 staff nurses, 137 nurse managers (NMs), and 8 chief nursing officers in Phase 1 and 7,849, 371 and 23 in Phase 2, respectively. The higher the job position, the better the WE was rated. The higher the PES-NWI scores, the better the outcomes. Descriptive statistics about organizational WEs and NOs and the statistically significant associations between the two were identified.