論文 - 春田　淳志

日本のプライマリ・ケア医のコロナワクチン接種の実践――スケーラビリティとノンスケーラビリティのはざまで

木村周平、堀口佐知子、後藤亮平、小曽根早知子、金子惇、照山絢子、濱雄亮、春田淳志

F1000Research （F1000 Research Ltd）  11   1268 - 1268 2022年

研究論文（学術雑誌）, 共著, 最終著者, 査読有り

　概要を見る

<p>Vaccine rollouts have been underway to combat the COVID-19 pandemic globally. Based on ongoing interviews with ten primary care physicians ‘in the field’, this paper elucidates how in practice the vaccinations were carried out in Japan in 2021. We examine what the primary care physicians did to prepare for the rollouts, what problems they faced, and how they responded to these problems. Large-scale vaccination projects are supposed to proceed smoothly and quickly, or to have what Anna Tsing calls ‘scalability’. In practice, however, they required a variety of tasks for coordination, information sharing, and promotion. Despite feeling stressed by the lack of information and exhausted by the work overload, the primary care physicians carried out the vaccinations as an important service to their patients and communities. The findings of this paper will provide valuable materials for improving future vaccine rollouts.</p>

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What kinds of work do Japanese primary care physicians who derive greater positive meaning from work engage in?

Yamamoto Y, Haruta J, Goto R, Maeno T

Journal of General and Family Medicine 2022年

研究論文（学術雑誌）, 共著, 査読有り

Family caregivers’ experience with healthcare and social care professionals and their participation in health checkups

Nakayama G, Masumoto S, Haruta J, Maeno T

Journal of General and Family Medicine 2022年

研究論文（学術雑誌）, 共著, 査読有り

【私のIPE体験】慶應義塾大学

尾崎 真友, 春田 淳志

日本保健医療福祉連携教育学会学術誌・保健医療福祉連携 （日本保健医療福祉連携教育学会）  15 （ 2 ） 114 - 115 2022年

ISSN  18836380

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What Role Expectations Do Primary Care Physicians in Japan Hold for Physical Therapists Regarding Primary Care?

Goto R., Haruta J., Ozone S.

Journal of Primary Care and Community Health （Journal of Primary Care and Community Health）  13   21501319221124316 - 21501319221124316 2022年

ISSN  21501319

　概要を見る

Introduction/Objectives: This study aimed to clarify what primary care physicians (PCPs) in Japan understand of the role of physical therapists (PTs) through the experience of working with PTs in hospitals, and what roles PCPs expect for PTs in future primary care. Methods: Semi-structured interviews were conducted individually with 9 purposively sampled PCPs with sufficient experience of collaboration with PTs. Interview data were analyzed by theme analysis focusing on “What does the PCP understand about the role of PTs through the experience of working with PTs in hospitals?” and “What roles and purposes does the PCP wish for PTs in primary care settings?” Results: PCPs viewed PTs as providers of rehabilitation in the traditional medical model, and understood their role as an occupation having a mono-causal viewpoint, namely a specific and well-defined outcome for individual patients, and intervening with patients within a short clinical course with the aim of improvement or maintenance of the patient’s condition. With regard to future primary care, PCPs expected that PTs would interpret various factors related to patient lives from the viewpoint of causal interactions; become important stakeholders in the community; and respond flexibly to patients and the environmental factors around them with continued support to the individual. Conclusions: PCPs understood the role of PTs in hospitals as “Rehabilitation in the traditional medical model,” and expected the future role of PTs in primary care as “Rehabilitation in integrated community care.”

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Relationship between the use of home-visit nursing services and family caregivers’ experience of interprofessional care

Nakayama G., Masumoto S., Haruta J., Maeno T.

Japanese Journal of Geriatrics （Japanese Journal of Geriatrics）  59 （ 2 ） 209 - 218 2022年

ISSN  03009173

　概要を見る

Aim: To examine the relationship between the use of home-visit nursing services (VNS) for patients and their family caregivers’ experience of interprofessional care, which is an indicator of the care process. Methods: We used data from a cross-sectional survey in Japan, 2020. Family caregivers 40-74 years old and caring for community-dwelling patients with chronic conditions were recruited. The outcome variable was family caregivers’ experience, reflecting the quality of interprofessional care for patients and their caregivers. We used the Japanese version of the Caregivers’ Experience Instrument (J-IEXPAC CAREGIVERS), which includes two domains: attention for the patient and attention for the caregiver. The main factor was the use of VNS, and covariates were socioeconomic factors of the caregivers and the use of other health and social care services. J-IEXPAC CAREGIVERS scores were divided into two groups by median values and analyzed by multivariate logistic regression analyses. Results: A total of 566 caregivers were included in the analysis. The median age was 62 years old. VNS was used in 86 cases (15.2%). Logistic regression analyses revealed that the use of VNS was significantly associated with a higher total score group for J-IEXPAC CAREGIVERS (odds ratio = 3.02; 95% confidence interval 1.54-5.91). Of the J-IEXPAC CAREGIVERS domains, attention for the patient was significant. Conclusions: We found that the use of VNS was likely to provide a better experience among family caregivers. Our findings sug-gest that visiting nurses fulfill their expected role as core members of a multidisciplinary team.

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Japan's General Practitioners' Responses to COVID-19 Transformations of the" Body Social" in Between Pandemic Waves

S Kimura, J Iida, J Teruyama, S Horiguchi, J Miyachi, Y Hama, J Haruta, ...

Japanese Review of Cultural Anthropology 23 (1), 337-342 2022年

Japan's General Practitioners' Responses to COVID-19

Kimura Shuhei, Iida Junko, Teruyama Junko, Horiguchi Sachiko, Miyachi Junichiro, Hama Yusuke, Haruta Junji, Ozone Sachiko, Kaneko Makoto, Goto Ryohei

Japanese Review of Cultural Anthropology （日本文化人類学会）  23 （ 1 ） 337 - 342 2022年

ISSN  24325112

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[How have Japanese primary care physicians carried out vaccinations against COVID-19? : Attempts at making the non-scalable 'scalable'].

Kimura S, Horiguchi S, Goto R, Iida J, Ozone S, Kaneko M, Teruyama J, Hama Y, Haruta J, Miyachi J

F1000Research 11   1268 2022年

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How have Japanese primary care physicians carried out vaccinations against COVID-19? : Attempts at making the non-scalable 'scalable'

Kimura S., Horiguchi S., Goto R., Iida J., Ozone S., Kaneko M., Teruyama J., Hama Y., Haruta J., Miyachi J.

F1000Research （F1000Research）  11 2022年

　概要を見る

Vaccine rollouts have been underway to combat the COVID-19 pandemic globally. Based on ongoing interviews with ten primary care physicians 'in the field', this paper elucidates how in practice the vaccinations were carried out in Japan in 2021 from a cultural anthropological perspective. We examine what the primary care physicians did to prepare for the rollouts, what problems they faced, and how they responded to these problems. Large-scale vaccination projects are supposed to proceed smoothly and quickly, or to have what Anna Tsing calls 'scalability'. In practice, however, they required a variety of tasks for coordination, information sharing, and promotion. Despite feeling stressed by the lack of information and exhausted by the work overload, the primary care physicians carried out the vaccinations as an important service to their patients and communities. The findings of this paper will provide valuable materials for improving future vaccine rollouts.

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文化人類学にとっての医学教育モデル·コア·カリキュラム改訂の意義

医療者向け人類学教育連携委員会, 木村 周平, 飯田 淳子, 伊藤 泰信, 倉田 誠, 錦織 宏, 浜田 明範, 春田 淳志, 星野 晋

文化人類学 （日本文化人類学会）  86 （ 3 ） 511 - 514 2021年12月

査読有り,  ISSN  1349-0648

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ICTを活用した多職種連携教育実践シリーズ　筑波大学での取り組み : 大学間連携による段階的な多職種連携教育 (1)

第21期 多職種連携教育部会, 後藤 亮平, 前野 貴美, 春田 淳志, 伊野 美幸, 石川 さと子, 内山 靖, 大槻 眞嗣, 加藤 博孝, 後藤 道子, 内藤 知佐子, 野呂瀬 崇彦, 吉見 憲二, 安井 浩樹

医学教育 （日本医学教育学会）  52 （ 6 ） 557 - 563 2021年12月

ISSN  0386-9644

　概要を見る

<p>　筑波大学の取り組みを2つに分けて報告する. 第1部では, 筑波大学と茨城県立医療大学の大学間連携教育プログラムであるインタープロフェッショナル演習を紹介する. COVID-19パンデミック前は, この演習はTBL (Team-based learning) の方法を用いて大会議室で行っていた. パンデミック後はこれをオンライン (Zoom使用) で実施した. オンライン実施により変更した点は以下の5点 ; (1)教員会議のオンライン化, (2)資料の事前配布, (3)Googleフォームを用いたテスト, (4)ブレイクアウト機能を用いたグループワーク, (5)Googleドキュメントを用いた同時編集, であった. 今後は, オンラインの多職種連携教育プログラムだからこそできる新たな教育方法の可能性を検討していきたい.</p>

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ICTを活用した多職種連携教育実践シリーズ　筑波大学での取り組み : 大学間連携による段階的な多職種連携教育 (2)

第21期　多職種連携教育部会, 前野 貴美, 後藤 亮平, 春田 淳志, 伊野 美幸, 石川 さと子, 内山 靖, 大槻 眞嗣, 加藤 博孝, 後藤 道子, 内藤 知佐子, 野呂瀬 崇彦, 吉見 憲二, 安井 浩樹

医学教育 （日本医学教育学会）  52 （ 6 ） 565 - 570 2021年12月

ISSN  0386-9644

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<p>　第2報第2部では, 筑波大学と東京理科大学の大学間連携プログラムであるケア・コロキウムを紹介する. ケア・コロキウムはPBL (Problem-based learning) 形式の多職種連携教育プログラムである. COVID-19パンデミックに対応し, このプログラムをMicrosoft Teamsを利用して, マニュアルの整備や通信テストなど事前準備を整えオンラインで実施し, 対面実施と同様の学びが抽出された. 卒前の多職種連携教育は大規模プログラムとなりやすく, 教員不足, 教室不足が障害となるが, オンライン教育ではこれらの障害を解決できる可能性がある. 対面とオンライン, 両者のメリットを生かしたハイブリッドプログラムの開発など今後の多職種連携教育の推進につながる可能性が考えられた.</p>

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What Types of Networks Do Professionals Build, and How Are They Affected by the Results of Network Evaluation?

Haruta J., Tsugawa S.

Frontiers in Public Health （Frontiers in Public Health）  9   758809 - 758809 2021年11月

　概要を見る

Background: We aimed to explore what kind of social networks characterizable as “consult/be consulted” are built among healthcare professionals in a community and the impact of providing the professionals with these findings. Methods: We adopted mixed methods exploratory study using social network analysis (SNA) and content analysis. SNA can visualize social network structures such as relationships between individuals. The healthcare professionals were asked about the key persons they consulted and were consulted by concerning these healthcare issues: (1) daily work; (2) a person with acute back pain; (3) a garbage-filled house reported by a neighbor; (4) a person with dementia; and (5) a study meeting. We identified the key roles depending on the issues using SNA. After analysis, the analytical findings were shared with the participants. To explore their cognitive responses, an open-ended questionnaire was delivered and a content analysis was implemented. Results: Of 54 healthcare professional participants, the data of 52 were available for analysis. The findings (in the respective order of the five topics above) were as follows: the number of nodes was 165, 95, 85, 82, and 68; clustering coefficient was 0.19, 0.03, 0.02, 0.11, and 0.23; assortativity was −0.043, −0.11, −0.23, −0.17, and −0.23; reciprocity was 0.35, 0.31, 0.39, 0.29, and 0.48. The top three centralities included nurses. Eighty-seven free comments were received, of which 39 were categorized as descriptive, 10 as analytical, and 38 as critical. Discussion: The structure of “consult/be consulted” networks differed by topic. SNA is available to detect the healthcare resources network and it may have helped them to reflect on their own networks.

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Validation of the professional self-identity questionnaire for medical students during clinical practice in Japan.

Haruta J, Maeno T, Takayashiki A, Goto R, Ozone S, Maeno T

International journal of medical education （International journal of medical education）  12   160 - 165 2021年08月

共著,  ISSN  2042-6372

　概要を見る

Objectives: To validate the Professional Self Identity Questionnaire (PSIQ) for medical students during clinical practice. Methods: We conducted a single-year longitudinal questionnaire study using the PSIQ. The PSIQ rates the nine items of "teamwork", "communication", "conducting assessment", "cultural awareness", "ethical awareness", "using records", "dealing with emergencies", "reflection", and "teaching" on a scale of 1-7 points. The study participants consisted of 118 fifth- and sixth-grade medical students who completed a mandatory 4-week clinical practice in a community-based medical education (CBME) curriculum. The data were collected before and after the CBME curriculum and after clinical practice at the time of graduation. To validate the internal structure of the PSIQ, we calculated Cronbach's alpha in the three phases. Additionally, to assess construct validity, we analyzed the trends and differences in each of the nine items of the PSIQ using repeated measures analysis of variance (ANOVA). We also showed the differences in effect size before and after the CBME curriculum. Results: The data of 105 medical students were analyzed. Cronbach's alpha in the three phases was 0.932, 0.936, and 0.939, respectively. PSIQ scores increased progressively for all items, and the F-test for repeated measures ANOVA of nine items' average score across the three phases showed a significant difference F(2,208) = 63.59, p<0.001. The effect size for professional identity of cultural awareness before and after the CBME curriculum was 0.67, or medium. Conclusions: We validated the PSIQ for medical students during clinical practice. Reflecting on professional identity may provide an opportunity for meaningful feedback on readiness to become a doctor.

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医学教育に社会科学を活かすために

飯田 淳子, 木村 周平, 伊藤 泰信, 倉田 誠, 浜田 明範, 星野 晋, 春田 淳志, 錦織 宏

医学教育 （日本医学教育学会）  52 （ 4 ） 342 - 344 2021年08月

査読有り,  ISSN  0386-9644

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診療所・小病院と地域中核病院の職員における「多職種連携」・「仕事の負担度」・「職場の満足度」・「近隣施設との関係性」に関する認識の比較

小森 聡子, 小曽根 早知子, 後藤 亮平, 春田 淳志

日本プライマリ・ケア連合学会誌 （(一社)日本プライマリ・ケア連合学会）  44 （ 1 ） 11 - 16 2021年03月

共著,  ISSN  2185-2928

　概要を見る

目的:診療所・小病院と地域中核病院の職員の多職種連携と仕事に対する認識を調査する.方法:診療所・小病院4施設,病院3施設の職員を対象に,Assessment of Interprofessional Team Collaboration Scale(AITCS)日本語版,Readiness for Interprofessional Learning Scale(RIPLS)日本語版,職場満足度,近隣施設との関係性をアンケート調査した.結果:対象者は診療所・小病院職員74人/病院職員576人,平均年齢は41.9歳/40.6歳,診療所・小病院職員の方がAITCS,RIPLS,職場満足度が有意に高く,近隣施設との関係性を良好と判断した.結論:多職種連携や仕事に対する認識が所属組織により異なることを理解することで,地域包括ケアシステムにおける垂直統合が推進される可能性がある.(著者抄録)

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「ソーシャルディスタンス」の時代のエスノグラフィー：デジタルプラットフォームを活用した調査を事例として

4． 照山絢子; 飯田淳子; 木村 周平; 堀口佐知子; 春田淳志; 濱雄亮; 金子惇; 宮地純一郎; 小曽根早知子; 後藤亮平

白山人類学 24   101 - 114 2021年03月

研究論文（学術雑誌）, 共著, 査読有り

「ソーシャルディスタンス」の時代のエスノグラフィー -デジタルプラットフォームを活用した調査を事例として-

照山, 絢子, 木村, 周平, 飯田, 淳子, 堀口, 佐知子, 春田, 淳志, 濱, 雄亮, 金子, 惇, 宮地, 純一郎, 小曽根, 早知子, 後藤, 亮平

白山人類学 = Hakusan Review of Anthropology （白山人類学研究会）  24   101 - 114 2021年03月

査読有り,  ISSN  1341-5980

The influence of family caregivers’ experience of interprofessional care on their participation in health checkups as preventive health behavior in Japan—a cross-sectional analysis

Nakayama G., Masumoto S., Haruta J., Maeno T.

International Journal of Environmental Research and Public Health （International Journal of Environmental Research and Public Health）  18 （ 1 ） 1 - 12 2021年01月

共著,  ISSN  16617827

　概要を見る

Background: The role of family caregivers has been vital, especially in superaging societies like Japan’s. The caregivers’ experience of interprofessional care is a key aspect in their evaluation of the quality of integrated care. We sought to explore whether family caregivers’ experience of interprofessional care is associated with their own participation in health checkups as preventive health behaviors. Methods: We used cross-sectional data obtained during the development of the Japanese version of the Caregivers’ Experience Instrument (J-IEXPAC CAREGIVERS). Participants who had provided care for at least one year were surveyed (n = 251). We assessed family caregivers’ experience of interprofessional care using J-IEXPAC CAREGIVERS and their participation in health checkups. Results: Multivariate logistic regression analysis revealed that the J-IEXPAC CAREGIVERS total score was significantly associated with the caregivers’ participation in health checkups [odds ratio per 1-point increase = 1.05; 95% confidence interval 1.01–1.09]. Two domain scores (attention for the patient and attention for the caregiver) of J-IEXPAC CAREGIVERS were significantly associated with the outcome. Conclusions: Family caregivers with more positive experiences of interprofessional care were more likely to participate in health checkups. These results support the significance of family caregivers’ experience of care, which may promote preventive health behaviors.

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