Details of a Researcher - Osaka, Wakako

Papers - Osaka, Wakako

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Influence of participation in a medical-themed Science Café on patient activation

Yuta Okazawa, Hayato Kizaki, Nobuyuki Suzuki, Wakako Osaka, Satoko Hori

Patient Preference Adherence (Patient Preference and Adherence) 17 3093 - 3106 2023.11

Accepted, ISSN 1177-889X

Purpose: This study aims to investigate the impact of a Science Café (SC) dealing with medical topics on participants’ patient activation (PA), a concept that refers to patients’ involvement in managing their own health, working with their healthcare providers, and maintaining their health. Material and Methods: Semi-structured interviews were conducted with patients who had participated in a medical SC (n = 10) to identify the medical SC-associated factors that influenced PA. Through a questionnaire of medical SC participants (n = 23), the impact on PA and correlations with relevant psychological measures were quantitatively assessed. Results: The interviews revealed three factors: “Experience & acceptance of chronic conditions”, “Features of medical SC” and “Changes as a result of participation.” The questionnaire results showed a positive correlation between PA and resilience and a negative correlation with decision regret. Conclusions: Participation in a medical SC by people with illnesses can improve PA by improving knowledge and skills for self-management and increasing self-awareness of illness in a supportive environment. The study highlights the potential benefits of using medical SC as a strategy for healthcare providers to improve PA and health outcomes.

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Development and acceptability of a decision aid for women with a BRCA pathogenic variant considering cancer risk management strategies

Okawa Megumi, Osaka Wakako

Journal of Hereditary Tumors (The Japanese Society for Hereditary Tumors) 22 ( 1 ) 9 - 16 2022.08

Research paper (scientific journal), Joint Work, Accepted

Women with a BRCA pathogenic variant are required to manage the risk of breast and ovarian cancer. Decision-making of the optimal strategy (e.g., prophylactic surgery, chemoprevention, or surveillance) is very complex and difficult due to uncertain effects and impact. This study aimed to develop a decision aid for women with a BRCA pathogenic variant and evaluate its acceptability. The International Patient Decision Aids Standards were used as a guide for an evidence-based development process. We created a prototype using the Ottawa Decision Support framework. During its development, we conducted required assessment from six experts. Once completed, its acceptability was assessed via semi-structured interviews, which included open-ended feedback, with 27 women with a BRCA pathogenic variant. All the participants felt the decision aid would have been helpful during their consultation and recommended it for future patients. However, many participants indicated the need for further information regarding the various symptoms after risk-reducing salpingo-oophorectomy and the cost of each medical strategy. Acceptability of the decision aid was high. Furthermore, based on the evaluation, it was further revised to meet the needs.

Shared decision making, physicians’ explanations, and treatment satisfaction: a cross-sectional survey of prostate cancer patients

Kazuhiro Nakayama, Wakako Osaka, Nobuaki Matsubara, Tsutomu Takeuchi, Mayumi Toyoda, Noriyuki Ohtake, Hiroji Uemura

BMC Medical Informatics and Decision Making (Springer Science and Business Media LLC) 20 ( 1 ) 334 - 334 2020.12

Research paper (scientific journal), Joint Work, Accepted

<title>Abstract</title><sec>
<title>Background</title>
Hormone therapy is one option for some types of prostate cancer. Shared decision making (SDM) is important in the decision making process, but SDM between prostate cancer patients receiving hormone therapy and physicians is not fully understood. This study tested hypotheses: “Patients’ perception of SDM is associated with treatment satisfaction, mediated by satisfaction with physicians’ explanations and perceived effective decision making” and “The amount of information provided to patients by physicians on diseases and treatment is associated with treatment satisfaction mediated by patients’ perceived SDM and satisfaction with physicians’ explanations.”

</sec><sec>
<title>Methods</title>
This cross-sectional study was conducted using an online panel via a private research company in Japan. The participants in this study were patients registered with the panel who had received or were currently receiving hormone therapy for prostate cancer and physicians registered with the panel who were treating patients with prostate cancer. Measures used in this study included a nine-item Shared Decision Making Questionnaire, levels of satisfaction with physicians’ explanations and treatment satisfaction, and effective decision making for patients (feeling the choice is informed, value-based, likely to be implemented and expressing satisfaction with the choice), and a Shared Decision Making Questionnaire for Doctors. The hypotheses were examined using path analysis.

</sec><sec>
<title>Results</title>
In total, 124 patients and 150 physicians were included in the analyses. In keeping with our hypotheses, perceived SDM significantly correlated with the physicians’ explanations and perceived effective decision making for patients, and satisfaction with physicians’ explanations and perceived effective decision making for patients were both related to treatment satisfaction. Although the amount of information provided to patients was correlated with the perceived SDM, it was indirectly related to their satisfaction with physicians’ explanations.

</sec><sec>
<title>Conclusions</title>
When physicians encourage patients to be actively involved in making decisions about treatment through the SDM process while presenting a wide range of information at the start of hormone therapy, patients’ effective decision making and physicians’ explanations may be improved; consequently, the patients’ overall treatment satisfaction may be improved. Physicians who treat patients with prostate cancer may have underestimated the importance of SDM before starting hormone therapy, even greater extent than patients.

</sec>

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Effect of a decision aid on the choice of pregnant women whether to have epidural anesthesia or not during labor

Eri Shishido, Wakako Osaka, Ayame Henna, Yuko Motomura, Shigeko Horiuchi

PLOS ONE (Public Library of Science (PLoS)) 15 ( 11 ) e0242351 - e0242351 2020.11

Research paper (scientific journal), Joint Work, Accepted

<sec id="sec001">
<title>Objective</title>
Decision aids (DAs) are useful in providing information for decision-making on using epidural anesthesia during birth. To date, there has been little development of DAs for Japanese pregnant women. Herein, we investigated the effect of a DA on the decision of pregnant women whether to have epidural anesthesia or not for labor during vaginal delivery. The primary outcome was changes in mean decision conflict score.

</sec>
<sec id="sec002">
<title>Methods</title>
In this non-randomized controlled trial, 300 low-risk pregnant women in an urban hospital were recruited by purposive sampling and assigned to 2 groups: DA (intervention) and pamphlet (control) groups. Control enrollment was started first (until 150 women), followed by intervention enrollment (150 women). Pre-test and post-test scores were evaluated using the Decision Conflict Scale (DCS) for primary outcome, knowledge of epidural anesthesia and satisfaction with decision making for secondary outcomes, and decision of anesthesia usage (i.e., with epidural anesthesia, without epidural anesthesia, or undecided).

</sec>
<sec id="sec003">
<title>Results</title>
Women in the DA group (n = 149: 1 excluded because she did not return post-test questionnaire) had significantly lower DCS score than those in the pamphlet group (n = 150) (DA: -8.41 [SD 8.79] vs. pamphlet: -1.69 [SD 5.91], p < .001). Knowledge of epidural anesthesia and satisfaction with decision-making scores of women who used the DA were significantly higher than those of women who used the pamphlet (p < .001). Women in the DA group showed a significantly lower undecided rate than those in the pamphlet group. The number of undecided women in the DA group significantly decreased from 30.2% to 6.1% (p < .001), whereas that in the pamphlet group remained largely unchanged from 40.7% to 38.9%.

</sec>
<sec id="sec004">
<title>Conclusion</title>
This study indicates that a DA can be useful in helping women make a decision whether to have epidural anesthesia or not for labor during vaginal delivery.

</sec>

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意思決定の葛藤をアセスメントするスクリーニングツールSURE test日本語版の開発　言語的妥当性を踏まえた翻訳版の作成

大坂和可子, 青木頼子, 江藤亜矢子, 北奈央子, 有森直子, 中山和弘

日本看護科学会誌 ((公社)日本看護科学学会) 39 334 - 340 2019.12

ISSN 0287-5330

目的:本研究の目的は,患者の意思決定の葛藤をスクリーニングするSURE(Sure of myself;Understand information;Risk-benefit ratio;Encouragement)test日本語版を,言語的妥当性を踏まえ開発することである.方法:SURE test日本語版は,第1段階:2名による順翻訳,第2段階:順翻訳統合,第3段階:2名による逆翻訳,第4段階:研究者協議(暫定版作成),第5段階:一般市民,医療者への調査,第6段階:再検討,を経て開発した.結果:暫定版作成後,第5段階の一般市民と医療者32名の調査において,「わかりやすい」と回答した割合は各項目で47%から78%であった.第6段階にて言語的妥当性を再検討し,日本語版を確定した.結論:一連の過程を経て,言語的妥当性を踏まえたSURE test日本語版を開発した.(著者抄録)

ディシジョン・エイドの質基準から見た説明文書の現状と課題　治験関係者へのインタビュー調査を含めて

藤田美保, 米倉佑貴, 大坂和可子, 中山和弘

臨床薬理 ((一社)日本臨床薬理学会) 50 ( 6 ) 247 - 257 2019.11

ISSN 0388-1601

ディシジョン・エイド(DA)の質基準を用いた説明文書評価と関係者へのインタビュー分析を行った。治験を含む臨床試験の説明文書20件を収集し分析したところ、DAとしての各説明文書のスコアは平均12.55点であり、全体として半数以上の評価項目の記載がなかった。DQ standards項目の記載については、領域1:意思決定のための選択肢に関する十分かつ詳細な情報提供のうち、「不参加」による利益および不利益に関する記載、「利益・不利益を比較する図表・工夫」に関してすべての説明文書に記載がなかった。また、患者7名、Institutional Review Board委員2名、治験責任医師2名、臨床研究コーディネータ3名、治験依頼者2名、計16名を対象にインタビューを実施した結果、「患者の利益・不利益の判断は暖昧」な場合があることや「不参加による利益・不利益の記載は不適切」という問題提起が見出された。

Decision coaching for people making healthcare decisions (Protcol)

Janet Jull, Sascha Köpke, Laura Boland, Angela Coulter, Sandra Dunn, Ian D Graham, Brian Hutton, Jürgen Kasper, Simone Maria Kienlin, France Légaré, Krystina B Lewis, Anne Lyddiatt, Wakako Osaka, Tamara Rader, Anne C Rahn, Claudia Rutherford, Maureen Smith, Dawn Stacey

Cochrane Systematic Review - Intervention - Protocol (Cochrane Database of Systematic Reviews) 2019 ( 7 ) 2019.07

Research paper (scientific journal), Joint Work, Accepted

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Development of a Linguistically Validated Japanese Version of the SURE test: Screening for Decisional Conflict in Patients

Osaka Wakako, Aoki Yoriko, Eto Ayako, Kita Naoko, Arimori Naoko, Nakayama Kazuhiro

Journal of Japan Academy of Nursing Science (Japan Academy of Nursing Science) 39 ( 0 ) 334 - 340 2019

Research paper (scientific journal), Joint Work, Accepted, ISSN 0287-5330

Purpose: To develop a linguistically validated Japanese version of the SURE (Sure of myself; Understand information; Risk-benefit ratio; Encouragement) test screening for decisional conflict in patients.Methods: We translated the original version, consisting of four items, into a preliminary Japanese version through four stages: Stage I comprised forward translation by two people; Stage II, integration of the two translations generated previously; Stage III, back translation by two people; and Stage IV, consultation by researchers and establishing the preliminary version. Further, Stage V comprised a survey for the clarity of items among general citizens and medical professionals, and during Stage VI, the instrument was revised based on the results of discussions among the research members obtained throughout this process.Results: The preliminary version of the instrument was developed during the first four stages. In the fifth stage, the result of a survey of 32 general citizens and medical professionals indicated that the percentage of respondents who answered "easy to understand" for each item was between 47% to 78%. In the sixth stage, we reviewed the linguistic validity, and the Japanese version of the SURE test was finalized.Conclusion: Throughout the process of translation, we developed the linguistically validated Japanese version of the SURE test.

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Effects of an Educational Program Promoting Breast Awareness for Early Detection of Breast Cancer

鈴木久美, 大畑美里, 林直子, 府川晃子, 大坂和可子, 池口佳子, 小松浩子

日本がん看護学会誌(Web) (Japanese Society of Cancer Nursing) 32 ( 0 ) ROMBUNNO.32_suzuki_20171120(J‐STAGE) - 22 2018

Joint Work, Accepted, ISSN 2189-7565

AbstractPurpose: The purpose of this study was to determine whether an educational program aimed at promoting breast awareness for early detection of breast cancer would encourage changes in behaviors and beliefs regarding breast cancer， breast self-examination, and mammography screening. Methods: We compared subjectsʼ behaviors and beliefs regarding breast self-examination and mammography screening before and after intervention, without a control group. Forty⊖two women, aged over 20 years and with no breast cancer history, consented to enroll in the study. They participated in an educational program conducted by ourselves and breast cancer survivors. Study outcomes consisted of the rates of performing regular breast self-examination and having mammography screening, and scores from Championʼs Health Belief Model Scale for Japanese （CHBMS-J）． Results: The mean participant age was 50.6 （SD=11.5） years; 59.5％ had an occupation, and 16.7％ had breast disease. One year after the intervention, the percentage of women who were performing regular breast self-examinations had risen significantly to 54.8％ from 21.4％（χ 2 =9.389, p＝0.002, effect size w=0.602）；the percentage who had undergone mammography screenings had also risen significantly, to 47.6％ from 23.8％（χ2 =8.100, p=0.004, effect size w＝0.569）．CHBMS-J scores for self-efficacy in breast self-examinations raised significantly at 1 and 6 months, and 1 year, after intervention （F=34.080, p＜0.001, effect size f=0.586）．More than 90％ of participants stated that they were satisfied with the program and found it useful and valuable. Conclusion: The program successfully enhanced self-efficacy in breast self-examination and motivation to undergo breast self-examination and mammography screening, thus raising rates of performance of breast self-examination and attendance for mammography screening.

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Trends in Patient-centered Decision Support and Use of Decision Aids in Surgical Treatment for Women with Early-stage Breast Cancer

大坂和可子, 山内英子

Oncoplastic Breast Surgery (Web) ((一社)日本乳房オンコプラスティックサージャリー学会) 3 ( 3-4 ) 51‐58(J‐STAGE) - 58 2018

Joint Work, Accepted, ISSN 2432-4647

乳癌患者が術式決定に参加できるよう支援し、決定プロセスを共有するシェアド・ディシジョン・メイキング(SDM)を実践することは、患者中心の医療において重要である。以下について概説した。1)3つの意思決定モデルとその歴史的推移、2)SDMとは何か、3)SDMにおける意思決定支援ツールとしてのディシジョンエイドの役割と効果、4)ディシジョンエイドに必要な要素、5)乳房再建を含む乳癌術式決定におけるディシジョンエイド、として述べた。

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Effect of a decision aid with patient narratives in reducing decisional conflict in choice for surgery among early-stage breast cancer patients: A three-arm randomized controlled trial

Wakako Osaka, Kazuhiro Nakayama

PATIENT EDUCATION AND COUNSELING (ELSEVIER IRELAND LTD) 100 ( 3 ) 550 - 562 2017.03

Research paper (scientific journal), Joint Work, Accepted, ISSN 0738-3991

Objective: We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer.
Methods: Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups.
Results: At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P = 0.021, Cohen's d = 0.26) and Group 2 vs control (P = 0.008, Cohen's d = 0.40).
Conclusion: The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer.
Practice implications: The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

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Evaluation of a Support Group for Women with Breast Cancer―Factors Affecting Patients’ Satisfaction with Group Experiences and Sense of Supportive Atmosphere―

大坂和可子, 川端, 愛, 細田志衣, 大畑美里, 矢ヶ崎香, 細川恵子, 我妻志保, 金井久子, 小松浩子

聖路加看護学会誌 (聖路加看護学会) 19 ( 2 ) 46 - 53 2016.01

Joint Work, Accepted, ISSN 1344-1922

乳がん体験者との協働による乳がん啓発教育プログラムの開発と評価

鈴木久美, 林直子, 片岡弥恵子, 樺沢三奈子, 大坂和可子, 今葷倍真紀, 大林薫, 小松浩子

保健の科学 (杏林書院) 57 ( 9 ) 638 - 643 2015.09

Joint Work, Accepted, ISSN 0018-3342

子育て期の女性および乳がん体験者が考える乳がん検診の受診を促進する要点

林直子, 鈴木久美, 今葷倍真紀, 片岡弥恵子, 大坂和可子, 大林薫, 小松浩子

保健の科学 ((株)杏林書院) 57 ( 8 ) 567 - 573 2015.08

Joint Work, Accepted, ISSN 0018-3342

関東および関西の都市部に在住する乳幼児から中学生までの子育て期の女性で、乳がんの既往がない者とサポートグループや患者会に参加している乳がん体験者を対象に、フォーカス・グループ・インタビューを用いて調査を行った。子育て期の対象者は関東1グループ5人、関西2グループ10人の3グループ計15人(平均年齢40.3歳)であった。乳がん体験者は14人(平均年齢52.6歳)で、サポートグループ参加者が10人、患者会参加者が4人であった。インタビューの録音データをもとに逐語録を作成し、コード化、カテゴリー化を行った。分析の結果、子育て期の女性、乳がん体験者双方から乳がん検診の受診を促進する要点として共通して、「受診しやすい検診システム」「意識への働きかけ」が挙げられた。検診受診あるいは検診継続を可能とする要因として、子育て期の女性の分析からは4カテゴリーが生成され、乳がん体験者の分析からは3カテゴリーが生成された。

Comprehensive health literacy in Japan is lower than in Europe: a validated Japanese-language assessment of health literacy

Kazuhiro Nakayama, Wakako Osaka, Taisuke Togari, Hirono Ishikawa, Yuki Yonekura, Ai Sekido, Masayoshi Matsumoto

BMC PUBLIC HEALTH (BIOMED CENTRAL LTD) 15 505 2015.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 1471-2458

Background: Health literacy, or the ability to access, understand, appraise and apply health information, is central to individuals' health and well-being. A comprehensive, concept-based measure of most dimensions of health literacy has been developed for the general population in Europe, which enables comparisons within and between countries. This study seeks to validate this tool for use in Japan, and to use a Japanese translation to compare health literacy levels in Japan and Europe.
Methods: A total of 1054 Japanese adults recruited through an Internet research service company, completed a Japanese-language version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). The survey was administered via an online questionnaire, and participant demographics were closely matched to those of the most recent Japanese national census. Survey results were compared with those previously reported in an eight-country European study of health literacy.
Results: Internal consistency for the translated questionnaire was valid across multiple metrics. Construct validity was checked using confirmatory factor analyses. The questionnaire correlated well with existing scales measuring health literacy and mental health status. In general, health literacy in the Japanese population was lower than in Europe, with Japanese respondents rating all test items as more difficult than European respondents. The largest difference (51.5 %) was in the number of respondents finding it difficult to know where to get professional help when they are ill.
Conclusions: This study translated a comprehensive health literacy questionnaire into Japanese and confirmed its reliability and validity. Comparative results suggest that Japanese health literacy is lower than that of Europeans. This discrepancy may be partly caused by inefficiency in the Japanese primary health care system. It is also difficult to access reliable and understandable health information in Japan, as there is no comprehensive national online platform. Japanese respondents found it more difficult to judge and apply health information, which suggests that there are difficulties in health decision-making in Japan.
Numerous issues may be linked to lower levels health literacy in Japan, and further studies are needed to improve this by developing individual competencies and building supportive environments.

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ヘルスリテラシー測定尺度HLS-EU-Q47日本語版の開発

中山和弘, 大坂和可子, 戸ヶ里泰典, 石川ひろの, 米倉佑貴, 松本真欣, 関戸亜衣

日本健康教育学会誌 (日本健康教育学会) 22 ( Suppl. ) 102 - 102 2014.07

Joint Work, Accepted, ISSN 1340-2560

成人女性の乳がんおよび乳がん検診・自己検診に対する意識調査

SUZUKI Kumi, HAYASHI Naoko, KABASAWA Minako, OHATA Misato, OSAKA Wakako, KATAOKA Yaeko, OHBAYASHI Kaoru, IKEGUCHI Yoshiko, KOMATSU Hiroko

保健の科学 (杏林書院) 55 ( 1 ) 63-70 - 70 2013.01

Research paper (scientific journal), Joint Work, ISSN 0018-3342

A Blended Learning Model of Peer Support Training Program for Women with Breast Cancer

KOMATSU Hiroko, YAGASAKI Kaori, OSAKA Wakako, YAMAUCHI Hideko, NAKAMURA Seigo

International Journal of Advanced Nursing Studies 1 ( 2 ) 58-72 2012

Research paper (scientific journal), Joint Work, ISSN 2227-488X

乳がん患者のためのピアサポート活動「聖路加スマイルコミュニティ」の実績報告乳がん体験者ボランティアと看護専門職の協働的パートナーシップによる取り組み

大坂和可子, 矢ヶ崎香, 金森亮子, 玉橋容子, 金井久子, 我妻志保, 細川恵子, 東由紀恵, 大畑美里, 鈴木久美, 小松浩子

聖路加看護大学紀要 (聖路加看護大学) ( 37 ) 36 - 41 2011.03

Joint Work, ISSN 0289-2863

聖路加看護大学看護実践開発研究センターではナースクリニックとして乳がん女性のためのサポートプログラムを開催している。プログラム参加者の提案をもとに、乳がん体験者と看護専門職との協働的パートナーシップにより新たなピアサポート活動を構築した。この提案は、仲間と出会う前に、乳がん体験により孤立感を感じ同じ体験を持つ人に誰にも言えない気持ちを話したいと感じた経験に基づくものであった。2008年10月より、研修プログラムを受講した先輩乳がん体験者ボランティアと看護専門職が協働し、悩みを持つ乳がん患者のためのピアサポート活動(「聖路加スマイルコミュニティ」)を開始した。月に2回の頻度で相談活動を行い2010年7月末日までに28名の乳がん患者(術前1名、術後27名)が利用した。利用者の平均年齢は49.82歳、利用時期は術後1年未満が最も多く16名であった。利用者の反応はおおむね良好であったが、今後は(1)活動を維持するための体制づくり、(2)運営体制の見直し、(3)ボランティアのスキルアップが求められている。(著者抄録)

Information sharing and case conference among the multidisciplinary team improve patients' perceptions of care.

Hiroko Komatsu, Kazuhiro Nakayama, Taisuke Togari, Kumi Suzuki, Naoko Hayashi, Yoshie Murakami, Yukiko Iioka, Wakako Osaka, Kaori Yagasaki, Seigo Nakamura, Joyce Neumann, Naoto T Ueno

The open nursing journal 5 79 - 85 2011

Research paper (scientific journal), Joint Work, Accepted

BACKGROUND: As the advent of genomic technology accelerates personalized medicine and complex care, multidisciplinary care is essential for management of breast cancer. OBJECTIVES: To assess whether healthcare delivery systems are related to patients' perceptions of care in breast cancer treatment institutions. METHODS: We conducted a cross-sectional nationwide study of breast cancer treatment institutions approved by the Japanese Breast Cancer Society in Japan. From 128 of the 457 institutions, 1,206 patients were included in the analysis. Each patient completed a questionnaire regarding perceptions of care that consisted of a multidisciplinary care subscale and a patient-centered care subscale. RESULTS: Multiple regression analysis revealed that the multidisciplinary care subscale was significantly related to implementation of patient-based medical record system that was paper-based (p<0.05). The results of the secondary analysis showed a significant relationship between the interdepartmental medical record system and the patient's perception of multidisciplinary care (p<0.05) and patient-centered care (p<0.05). When a multidisciplinary case conference took place regularly or multidisciplinary viewpoints were incorporated into the conference records, the conference had a significantly higher correlation with both subscales (p<0.001). CONCLUSIONS: Integrated patient-based information and regular multidisciplinary case conferences that include records of viewpoints from different professionals improve patients' perceptions of comprehensive breast cancer care.

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