Suchergebnisse

Abstract Background Over the last decade, patient involvement in treatment-related decision-making has been widely advocated in Japan, where patient-physician encounters are still under the influence of the long-standing tradition of paternalism. Despite this profound change in clinical practice, studies investigating the actual preferences of Japanese people regarding involvement in treatment-related decision-making are limited. The main objectives of this study were to (1) reveal the actual level of involvement of Japanese cancer patients in the treatment-related decision-making and their overall satisfaction with the decision-making process, and (2) consider the practical implications of increased satisfaction in cancer patients with regard to the decision-making process. Methods We conducted semi-structured interviews with 24 Japanese cancer patients who were recruited from a cancer self-help group in Tokyo. The interviews were qualitatively analysed using the approach described by Lofland and Lofland. Results The analyses of the patients' interviews focused on 2 aspects: (1) who made treatment-related decisions (the physician or the patient), and (2) the informants' overall satisfaction with the decision-making process. The analyses revealed the following 5 categories of decision-making: 'patient as the active decision maker', 'doctor selection', 'wilfully entrusting the physician', 'compelled decision-making', and 'surrendering decision-making'. While the informants under the first 3 categories were fairly satisfied with the decision-making process, those under the latter 2 were extremely dissatisfied. Informants' views regarding their preferred role in the decision-making process varied substantially from complete physician control to complete patient control; the key factor for their satisfaction was the relation between their preferred involvement in decision-making and their actual level of involvement, irrespective of who the decision maker was. Conclusion In order to increase patient satisfaction with regard to the treatment-related decision-making process, healthcare professionals in Japan must assess individual patient preferences and provide healthcare accordingly. Moreover, a better environment should be created in hospitals and in society to facilitate patients in expressing their preferences and appropriate resources need to be made available to facilitate their decision-making process.

Previous literature pointed out that the role of care managers is ambiguous. In 2000, Japan instituted a new policy for long-term care of the elderly (the National Long-Term Care Insurance Policy), within which the work of care managers was recognized as a new profession providing care management services for the elderly needing care. We conducted a random-sampled mail survey on 530 care managers in 268 organizations to clarify the association between role ambiguity and care managers' work environments, including role clarification, organizational profit-seeking climate, and the utilization of professional and personal support. The results showed that fewer opportunities for role clarification and increased organizational profit-seeking climate were associated with greater role ambiguity for care managers. Furthermore, emotional and instrumental support from colleagues and external resources were positively associated with role ambiguity, while informational support from superiors was negatively associated with role ambiguity. Role clarification and the utilization of support within and outside of work organizations would be beneficial to reduce the role ambiguity of care managers.

At the beginning of the twenty-first century, both Britain and Japan are facing similar issues caused by globalisation, slower economic growth, and a rapidly ageing population. Social policy in the two societies, which has developed differently due to the differences in their national resources, socio-economic systems, cultural values and political agendas, is at an interesting turning point. Comparing social policies: examines topical issues with up-to-date information; compares and contrasts selected policy areas between the two societies; presents original material written by leading scholars in each country. This original book will be of great interest to academics and students, as well as policy makers and practitioners internationally, who are interested in various fields of social policy in Britain and Japan

AbstractIn Japan, risk behaviors for cancer remain inadequately controlled, often due to a lack of necessary information and support to guide consumers in cancer control decisions. The use of strategic health communication efforts based on social marketing has substantial potential to provide groups of consumers who are underinformed or misinformed with relevant cancer information, both to reinforce their cancer awareness, knowledge, attitudes, and beliefs and to strengthen behaviors to prevent cancer. The INFORM Study monitors these variables nationally and identifies populations most in need of cancer‐related information. A nationally representative cross‐sectional mail survey was used to investigate consumer behaviors related to cancer prevention and screening, as well as cancer knowledge, attitudes and beliefs, and access to and use of trusted cancer information. A total of 10,000 Japanese aged 20 years or older were selected by two‐stage stratified random sampling. The self‐administered questionnaire consisted of core items from the Health Information National Trends Survey in the United States with some additional items not covered in HINTS but important in Japan. This national survey is expected to play an important role in promoting effective dissemination of evidence‐based recommendations.