Home In Japan Research Articles

The Correlation Between the Attended Deaths at Home and Medical Resources in Osaka City.

Introduction Most people would preferend-of-life care to be provided at home. Although Japan has tried to promote home care and end-of-life care, very few people die at home in Japan. On the other hand, deaths at home are not necessarily attended deaths at home by end-of-life care because they include many deaths, such as deaths from external causes and solitary deaths. We obtained the data on the number of postmortem examinations at home in the main areas of Osaka City and calculated the estimated number of attended deaths at home by subtracting the number of postmortem examinations at home from the number of total deaths at home. We analyzed the contribution of medical resources to end-of-life care from a forensic perspective for a closer analysis of the actual situation. Methods The data about the population, the number of total deaths, deaths at home, and medical resources related to home care in Osaka City was obtained from the website of a public institution in Japan. The data about the number of postmortem examinations in Osaka City was obtained from the Osaka Medical Examiner's Office. The estimated number of attended deaths at home was calculated by subtracting postmortem examinations at home from total deaths at home. We conducted univariate and multivariate analyses between the number of medical resources and the prevalence of attended deaths at home. Results In the univariate analysis of the prevalence of attended deaths at home, a high positive correlation was observed in "doctors,""total clinics,""clinics except HCSC,"and "general beds."A high negative correlation was observed in "long-term care beds."In the multivariate analysis, a positive coefficient was observed in "clinics except HCSC,"and a negative one was observed in "HCSC or HCSH." Conclusion The policy of shifting general clinics and hospitals to HCSC and HCSH may not be as effective for end-of-life care because the criteria do not include any restrictions on the number or use of beds. However, general clinics may have played an important role in end-of-life care, even if they were not HCSC.

Unplanned Hospital Visits and Poor Oral Health With Undernutrition in Nursing Home Residents

ObjectivesIn 2021, the Japanese government began operating a long-term care (LTC) database called the Long-Term Care Information System for Evidence (LIFE). However, its utility has not been verified. Regarding unplanned hospital visits of nursing home residents, one of the challenges in LTC is that poor oral health with undernutrition could indicate high-risk residents. Therefore, this study examined the association between poor oral health with undernutrition assessed using the LIFE data and unplanned hospital visits of nursing home residents. DesignRetrospective cohort study. Setting and ParticipantsThe participants were 237 residents aged ≥65 years in 4 nursing homes in Japan. The analyses included 1041 LIFE data entries repeatedly measured for the participants every month and unplanned hospital visit data during the observation period. MethodsThe participants' LIFE and unplanned hospital visit data were obtained from the nursing home providers. Poor oral health was defined using oral items included in the LIFE data and body mass index. Using the LIFE data, the association between poor oral health and unplanned hospital visits within 1 month after LIFE assessment entries was analyzed. The odds ratios (ORs) and 95% CIs were calculated using a generalized linear mixed model. ResultsIn total, 59 of 1041 LIFE data (5.7%) entries were unplanned hospital visits within 1 month after LIFE assessment. Among patient characteristics, significant differences were noted in dementia diagnosis [OR (95% CI): 2.66 (1.26-5.63)], although no significant differences were observed in other characteristics. Multivariate analysis using participant identification as a random effect confirmed that poor oral health was associated with unplanned hospital visits within 1 month [adjusted OR (95% CI): 2.63 (1.05-6.61)]. Conclusions and ImplicationsPoor oral health assessed using the LIFE data could be used as an indicator to identify nursing home residents at high risk for unplanned hospital visits.

Mental health status of children who use foreign languages at home in Japan.

Little is known about the mental health status of children in Japan whose roots are in foreign countries. The differences in language that are used every day may be a factor that makes adaptation difficult for these children. The aim of the present study, therefore, was to examine the mental health status of children who use foreign languages at home via a cross-sectional survey in a large cohort. The survey was conducted among children who attended public elementary and junior high schools in a large city in Japan. Data were received from 20,596 elementary school-aged (above 4th grade) and 19,464 junior high school-aged children. We compared mental health status evaluated by the Patient Health Questionnaire-4 in the group based on language usage at home (only Japanese, only foreign languages, and both languages). We found that children who used foreign languages at home exhibited worse mental health status than children who used only Japanese at home. In addition, mental health status was slightly better among junior high school-aged children who used only foreign languages at home than among elementary school-aged children. This tendency was not observed in the group of children who used both languages at home. Our results suggest that children in Japanese society who use foreign languages at home have worse mental health, therefore there is a need for support for these children living in Japan.

On the Work Autonomy Supported by Information and Communication Technology A Case Study of Work from Home in Japan before the COVID-19 Epidemic.

Telecommuting increased during the COVID-19 pandemic. To make telecommuting the "new normal," it is essential to not only change the legal system and employment contracts but also reform organizational processes. Prior research has demonstrated a positive correlation between telecommuting and perceived autonomy using questionnaire surveys, but the lack of a widely accepted measurement scale to capture the reality of telecommuting has hindered the capacity to understand its current status. In this study, we conducted unstructured interview surveys to elucidate the mechanisms of the relationship of perceived autonomy and telecommuting, while focusing on perceived autonomy in organizational processes. The paper is organized as follows: it reviews previous studies on telecommuting and describes the related advantages and disadvantages; examines changes in the environment and attitudes based on interviews conducted with employed telecommuters; examines changes in telecommuters' attitudes toward perceived autonomy.

User Intent-Based Segmentation Analysis for Internet Access Services

The Internet is available for almost all homes in Japan. During the diffusion stage of Internet access services, it was important to construct a model to evaluate the sensitivity for Internet access service attributes and estimate user service choice behavior to consider service sale strategies. However, as the demand for Internet access services reached saturation, the differences in service attributes among service providers became smaller, making it difficult to decide service sale strategies using conventional choice behavior models. Therefore, the purpose of this paper is to establish a method for extracting effective information for service sale strategies by focusing on user intentions and clarifying the differences in future intentions for current carriers or services with observable and unobservable factors concerned with user intention. The authors propose a framework for user intent-based segmentation to understand the current market structure and develop appropriate service sales strategies for each segment.

Working environment at home and mental health in employees working from home in Japan during COVID-19 pandemic: A cross-sectional study.

This cross-sectional study aimed to examine the associations of a poor working environment at home with psychological distress and psychosomatic symptoms in employees working from home in Japan during the COVID-19 pandemic. The data obtained in October 2021 from an online cohort of full-time employees (E- COCO- J) were used. Participants who worked from home for at least some days per month were included. The poor working environment at home was assessed using 11 items based on the Japanese Ministry of Health, Labour and Welfare recommended checklist. The score ranged from 0 to 11. Psychological distress and psychosomatic symptoms were measured by the Brief Job Stress Questionnaire (BJSQ). The associations between total scores of poor working environment and outcomes were examined by multiple regression analysis, adjusted by age, sex, education, living with family, frequencies of working from home, company size, job demand, job control, and workplace social support. Two hundred twenty-six employees who were working at home were included. The mean of the summed scores of poor working environments at home was 2.75. After adjusting the covariates, summed scores of poor working environments were significantly associated with high psychological distress (standardized β = 0.21, P = .003) and with high psychosomatic symptoms (β = 0.19, P = .005). For each poor environment, lack of ventilation and difficulty staying hydrated or resting were significantly associated with both outcomes. Even after adjusting for job stressors and support, working environments at home were associated with employees' mental health. Appropriate measures and education may be needed.

Diversity of Chlamydiales detected in pet birds privately kept in individual homes in Japan.

Chlamydia-related bacteria of the Chlamydiales order have recently been described as emerging pathogens that cause pneumonia and abortion in animals and humans. We investigated the presence of Chlamydiales using real-time polymerase chain reaction (PCR) by targeting the 16S rRNA gene of a broad range of Chlamydiales in 827 fecal samples from pet birds kept in individual homes in Japan. Of the 827 samples, 493 (59.6%) tested positive for the Chlamydiales 16S rRNA gene in the real-time PCR assay. We determined the nucleic acid sequences of PCR products from 17 Chlamydiales strains. A homology search and phylogenetic analysis using these sequences confirmed that the detected Chlamydiales included C. pecorum and a broad range of Chlamydia-related bacteria. To the best of our knowledge, this is the first study to detect a wide range of Chlamydia-related bacteria in birds.

A comparative study of mother-infant co-regulation of distance at home in Japan and Scotland

Mothers and infants co-regulate their distance from one another at home. Continuous, naturalistic home observations of the changes in mother-infant distance were carried out in Japan and Scotland during infant ages of 0–1, 6–7, and 12–13 months. This study examined mutual distance-increasing and distance-reducing behaviours, referred to as parent-infant ‘centrifugalism’ and ‘centripetalism’. Cultural differences emerged in the modes of mother-infant distance co-regulation. Scottish mothers were more active in initiating contact and leaving infants alone to sleep, whereas Japanese mothers showed stronger infant-centredness by maintaining physical contact with infants when they fell asleep and reacting to their crying when they woke up. Age differences were found relating to decrease in sleep and increase in object play in the middle of the first year, which resulted in more separation within a 0.5 m distance at 6–7 months, a compromise between closeness and distancing between mothers and awake infants. Cultural and age differences in the co-regulation of mother-infant distance were discussed in relation to the development of locomotion, object play, and intention-reading.

Mobile health technology as a solution to self-control problems: The behavioral impact of COVID-19 contact tracing apps in Japan

RationaleMobile technology has been widely utilized as an effective healthcare tool during the COVID-19 pandemic. Notably, over 50 countries have released contact-tracing apps to trace and contain infection chains. While earlier studies have examined obstacles to app uptake and usage, whether and how this uptake affects users’ behavioral patterns is not well understood. This is crucial because uptake can theoretically increase or decrease behavior that carries infection risks. ObjectiveThe goal of this study is to evaluate the impact of app uptake on the time spent out of home in Japan. It tests four potential underlying mechanisms that drive the uptake effect: compliance with stay-at-home requirements, learning about infection risk, reminders, and commitment device. MethodWe use unique nationwide survey data collected from 4,379 individuals aged between 20 and 69 in December 2020 and February 2021 in Japan. Japan has features suitable for this exercise. The Japanese government released a contact tracing app in June 2020, which sends a warning message to users who have been in close contact with an infected person. We conduct a difference-in-differences estimation strategy combined with the entropy balancing method. ResultsApp uptake reduces the time spent out of home. Sensitivity analysis shows that it cannot be explained by unobserved confounders. Importantly, the impact is large even among users who have not received a warning message from the app, and even larger for those with poor self-control ability. Furthermore, individuals’ self-control ability is negatively associated with the uptake decision, supporting our hypothesis that the apps serve as a commitment device. ConclusionsIt may be beneficial to encourage citizens to uptake contact tracing apps and other forms of commitment devices. This study also contributes to the literature on mobile health (mHealth) by demonstrating its efficacy as a commitment device.

Epidemiology of adverse drug events and medication errors in four nursing homes in Japan: the Japan Adverse Drug Events (JADE) Study

BackgroundWorldwide, the emergence of super-ageing societies has increased the number of older people requiring support for daily activities. Many elderly residents of nursing homes (NHs) take drugs to treat chronic...

COVID-19 and mandatory teleworking from home in Japan: taking stock to improve satisfaction and job performance

PurposeThis exploratory paper aims to examine attitudes and practices with regard to the COVID-19 pandemic, as well as the effects of mandatory teleworking from home in the wake of the first state of emergency orders in Japan in 2020.Design/methodology/approachAn online survey of married employees retrospectively assessed changes in work style, subjective well-being, work–family conflict and job performance before and during forced teleworking from home in Tokyo and three of the surrounding prefectures.FindingsRegular employees reported high levels of anxiety and to have thoroughly implemented government-recommended hygiene and safety practices. A majority of respondents were satisfied with mandatory telework from home and desired to continue partial telework after the end of the pandemic. The strongest predictor of satisfaction with mandatory telework from home turned out to be adequate workspace at home for both men and women. However, the antecedents of the desire to continue working from home differed by gender.Practical implicationsThese findings can help individuals, firms and governments better understand the effects of mandatory teleworking from home and devise countermeasures to maximize employee well-being and job performance. This is all the more crucial, as Japan has had successive waves of the virus and has declared numerous states of emergency since the beginning of the pandemic, forcing office workers to continue social distancing and remote working for the time being.Originality/valueTo the best of the authors’ knowledge, this research is one of the first to provide insights on how imposed teleworking from home in the context of COVID-19 in Japan affected regular employees’ personal and professional lives and to identify predictors of satisfaction with teleworking and the desire to continue doing so.

Pilot experimental study; Effect of environmental stimulation consisting of sound with high-frequency components, aromas, and light exposure from organic light-emitting diodes (OLEDs) toward rest-activity rhythm in institutionalized patients with dementia

Environmental stimulation is expected to have a positive impact on night sleep, psychological or functional states in dementia. The objective of this pilot study was to examine the effects of environmental stimulation consisting of sounds with high-frequency components, aromas, and light exposure from organic light-emitting diodes (OLEDs) to create comfortable living spaces for persons with dementia. Subjects (n =6) were recruited from elderly persons admitted to a single nursing home in Akita Prefecture, Japan, between August and September 2020. The night-time sleep state, the rest-activity rhythm, and the light exposure of the subjects living in environments with or without environmental stimulation consisting of sounds with high-frequency components, aromas, and light exposure from OLEDs were measured for 46.3 consecutive days using wrist activate devices under free-living conditions in a nursing home. In a period of environmental stimulation depending on the presence or absence of sounds with high-frequency components, reduction of the fragmented rest-activity rhythms was significantly observed in the subjects (p < 0.05). However, changes in the night-time sleep state had no significant difference during the study period. In conclusion, these preliminary results suggest that future examinations are warranted not only to inform effective or comfortable living conditions for elderly persons with dementia but also to improve the disruption of rest-activity rhythms in persons with dementia.

Impacts of Working from Home on Urban Structure：

This article, using data from original employee surveys conducted in 2020 and 2021, overviews the adoption, intensity, and productivity of working from home in Japan since the onset of the COVID-19 pandemic. Based on the evidence, I discuss possible impacts of the diffusion of working from home on urban structure. Although working from home will be a factor of reallocation of population within commuting distance, its impact on countrywide reallocation is unlikely to be quantitatively significant.

Over Half of Falls Were Associated with Psychotropic Medication Use in Four Nursing Homes in Japan: A Retrospective Cohort Study.

Medication use can increase the risk of falls and injuries in nursing homes, creating a significant risk for residents. We performed a retrospective cohort study over one year to identify the incidence of drug-related falls with and without injury among four Japanese nursing homes with 280 beds. We evaluated the relationship between potential risk factors for falls and fall-related injuries while considering well-known risks such as ADLs and chronic comorbidities. By collaboratively reviewing care records, we enrolled 459 residents (mean age, 87) and identified 645 falls, including 146 injurious falls and 16 severe injurious falls requiring inpatient care, incidence: 19.5, 4.4, 0.5 per 100 resident-months, respectively. Medication influenced around three-quarters of all falls, >80% of which were psychotropic drugs. Regularly taking ≥5 medications was a risk factor for the initial falls (HR 1.33: CI 1.00–1.77, p = 0.0048) and injuries after falls (OR 2.41: CI 1.30–4.50, p = 0.006). Our findings on the incidence of falls with and without injury were similar to those in Western countries, where the use of psychotropic medication influenced >50% of falls. Discontinuing unnecessary medication use while simultaneously assessing patient ADLs and comorbidities with physicians and pharmacists may help to avoid falls in nursing homes.

Capturing Changes in Residential Occupant Behavior Due to Work from Home in Japan as a Consequence of the COVID-19 Pandemic

Since there is a possibility that work from home will become one of the major working styles in the era of a new normal after the COVID-19 pandemic, it is necessary to examine an effect of work from home on life of residents at home and on energy consumption. Therefore, a web-based questionnaire survey was conducted at the end of October 2020 for households in which any of the family members was a work from home worker. In regard to the changes in life schedule, work from home helped 21.5% of respondents to sleep 30 min more or even longer. This shows that the loss of commuting time to work due to work from home improved the health of respondents in terms of sleep. In terms of the changes in energy consumption, more than a quarter of households experienced an increase in electricity consumption. Around 40~50% of households whose monthly electricity consumption increased from last year were not aware of the reasons for the increase or realized it for the first time when they answered the questionnaire survey. This indicates that feedback using home energy management systems, etc., play an important role in promoting energy-saving behavioral changes. An analysis of the causes of the increase in energy consumption by households reveals that the increase in hours of use of air-conditioners is significantly correlated with the increase in household electricity consumption in August (p = less than 0.01). The large-scale questionnaire survey on Japanese housing during the COVID-19 pandemic in this study elucidated that work from home as a countermeasure against COVID-19 infection affected the residents’ lives and the energy consumption of each household. This paper also showed the causes of the increase in household energy consumption and the importance of feedback, such as HEMS, in promoting energy-saving behavior. These results are expected to help to improve health of residents and energy saving in the era of a new normal.

The Systematic Workplace-Improvement Needs Generation (SWING): Verifying a Worker-Centred Tool for Identifying Necessary Workplace Improvements in a Nursing Home in Japan.

This study developed and tested a new measurement instrument, the Systematic Workplace-Improvement Needs Generation (SWING), to identify workplace-improvement needs. The participants were 53 workers in a Japanese nursing home for the elderly. The respondents used the SWING questionnaire to self-generate five ‘cues’ they considered important to improve the workplace. The workers determined each cue’s sufficiency level and weight balance (importance), and then we summarised the 265 cues into 21 categories for workplace improvements. The respondents identified the following items as the most important and the least sufficiently provided areas for workplace improvement: ‘interaction with customers’, ‘physical and psychological harassment’, ‘rewarding and challenging work’, and ‘sharing goals and objectives’. Although the workplace-improvement recommendations differed greatly from person to person, SWING prioritised the items by weight (importance) and sufficiency (current status), allowing organisations to address the needed improvements systematically. The SWING tool effectively elicited and prioritised respondents’ recommendations for improving the workplace. Because its items are self-generated by the respondents, SWING can be used for any occupation or workplace. Visualisation with bubble plots to clarify the improvement needs is incorporated into SWING.

Gender differences in housework and childcare among Japanese workers during the COVID-19 pandemic.

ObjectivesAlthough gender stereotypes regarding paid work and unpaid work are changing, most wives are responsible for taking care of the family and home in Japan. It is unclear how time spent on housework and childcare has changed between working men and women during the COVID‐19 pandemic in Japan. The purpose of this study is to investigate how working men and women’s responsibilities for housework and childcare changed during the COVID‐19 pandemic in Japan depending on work hours, job type, the number of employees in the workplace, and frequency of telecommuting.MethodsA cross‐sectional analysis (N = 14,454) was conducted using data from an Internet monitoring study (CORoNa Work Project), which was conducted in December 2020. A multilevel logistic model with nested prefectures of residence was conducted to estimate the odds ratio (OR) for change in time devoted to housework and childcare among men and women adjusting for age, household income, presence of spouse who work, work hours, job type, the number of employees in the workplace, frequency of telecommuting, and the incidence rate of COVID‐19 by prefecture.ResultsMore women tended to perceive that their time of housework and/or childcare had been changed (increased housework: OR 1.92, 95% CI [1.71–2.16], P < .001; decreased workhours: 1.66 (1.25–2.19), P < .001: increased childcare: OR 1.58, 95% CI [1.29–1.92], P < .001; decreased childcare: 1.11 (0.62–2.00), P = .719).ConclusionsThe time spent by women on housework and childcare changed significantly compared to men during the COVID‐19 pandemic in Japan.

Who Has Benefited from Nursing Home Expansion in Japan?: The Effects of Government Supply-Side Intervention in the Elderly Care Market

This study analyzes the relation between the labor force participation of caregivers and the provision of informal in-home elderly care. In Japan, the national government both regulates the market entry of nursing home suppliers and intervenes in the supply side of the eldercare market. Using exogenous variations in this supply side intervention, our analysis finds that the Japanese policy of expanding nursing homes has increased the labor force participation of female workers with low opportunity costs in the labor market while simultaneously reducing their provision of informal care. As the per capita expense of nursing home care is higher than the wage income of most non-regular female workers who tend to provide the bulk of informal in-home care, one may reasonably conclude that the capacity of public nursing homes in Japan has expanded excessively, putting unnecessary pressure both on the Japanese budget and the personal provision of eldercare services.

Implementation of an Advance Care Planning Inventory and Its Possible Effect on Quality of Dying: A Nationwide Cross-Sectional Study in Group Homes for Persons with Dementia in Japan.

This study aimed to develop an inventory for advance care planning implementation for persons with dementia in group homes and to examine the association between inventory implementation and residents’ quality of dying. A nationwide cross-sectional study was conducted via questionnaires mailed from 2000 group homes in Japan, selected through stratified random sampling. Participants were managers and care planners who had provided end-of-life care for recently deceased residents. The newly developed inventory was used to assess advance care planning implementation for persons with dementia, and the Quality of Dying in Long-term Care Scale was used to evaluate quality of dying. The valid response rate was 28.5% (n = 569). The factor structure of the newly developed Advance Care Planning Practice Inventory and the association between its implementation and quality of dying were verified using factor analysis and internal consistency, and logistic regression, respectively. The composite score and the factor score of the newly developed inventory were significantly associated with quality of dying (p < 0.05). The implementation of advance care planning improves the quality of dying. These findings can be used in development of educational programs, as well as research on advance care planning for care providers.

Preventable? Long-Term Care Policy Successes and Failures During COVID-19 Pandemic: A Scoping Literature Review

The number of older adults who live in long-term care (LTC) is expected to increase worldwide. The COVID-19 pandemic has caused serious consequences in Canadian LTC homes, while homes in China and Japan reported minimal infection and death rates in residents. The differences in LTC policies may be one of the contributors. The purpose of this literature review was to identify elements of the LTC policies that might have impacted COVID-19 outcomes in LTC homes in Canada, China, and Japan. A scoping review was conducted following the framework proposed by Arksey and O’Malley. Scholarly articles and grey literature published between January 2015 and June 2020 were identified in six databases, four in English (CINAHL, Scopus, ProQuest, and PubMed), one in Chinese (CNKI), and one in Japanese (CiNii), using MeSH terms for LTC and health policy. Grey literature was identified using Google. Data were extracted, summarized and common themes identified through content analysis. A total of 52 articles and 26 grey sources were included in the review based on determined inclusion criteria. They were research articles, reviews, government or association reports, policy briefs, policy documents, and guides. Four common themes of challenges emerged: caregiver workforce, service provision, funding, and physical environments. Three sub-themes were identified for caregiver workforce and service provision. Differences in COVID-19 consequences in LTC homes in the three countries seem to be related mainly to the challenges with the caregiver workforce and the lack of funding. The result suggests Improvements of LTC policies are required, especially in Canada.