Details of the Researcher

PHOTO

Miharu Nakanishi
Section
Graduate School of Medicine
Job title
Associate Professor
Degree

  • 博士（保健学）（東京大学）

  • 修士（保健学）（東京大学）

e-Rad No.
40502315
Profile

I am a registered nurse and researcher on health services research in dementia, palliative and end-of-life care.

I am currently working for the European Association for Palliative Care taskforce advance care planning for dementia.

I have devoted to development, dissemination and implementation of Tokyo psychosocial dementia care programme in collaboration with Swedish team. I am still working for Tokyo programme as a data manager and collaborating with Dutch team that is also developing the cultural adaptation of the programme.

Research History 9

  • 2023/06 - Present
    Leiden University Medical Center　Departent of Public Health and Primary Care　Visiting researcher

  • 2022/11 - Present
    Tokyo Metropolitan Institute of Medical Science　Research Center for Social Science & Medicine　Research Fellow

  • 2021/04 - Present
    Tohoku University　Department of Psychiatric Nursing, Graduate School of Medicine　Associate Professor

  • 2020/04 - 2021/03
    Tokyo Metropolitan Institute of Medical Science　Unit for Mental Health Promotion, Research Center for Social Science & Medicine　Chief Researcher

  • 2015/04 - 2020/03
    Tokyo Metropolitan Institute of Medical Science　Department of Psychiatry and Behavioral Science, Mental Health and Nursing Research Team　Chief Researcher

  • 2014/03 - 2015/03
    Tokyo Metropolitan Institute of Medical Science　Department of Psychiatry and Behavioral Science, Mental Health and Nursing Research Team　Senior Researcher

  • 2009/04 - 2014/02
    Institute for Health Economics and Policy　Research Department　Senior Researcher

  • 2006/04 - 2009/03
    Institute for Health Economics and Policy　Research Department　Researcher

  • 2005/04 - 2006/03
    National Institute of Mental Health, National Center of Neurology and Psychiatry　Department of Social Psychiatry　Research Resident

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Education 3

  • The University of Tokyo, Graduate School of Medicine　Division of Health Sciences and Nursing　Department of Mental Health, Doctoral course

    2002/04 - 2005/03

  • The University of Tokyo, Graduate School of Medicine　Division of Health Sciences and Nursing　Department of Mental Health, Master's course

    2000/04 - 2002/03

  • The University of Tokyo　School of Health Sciences and Nursing

    1996/04 - 2000/03

Committee Memberships 12

  • European Association for Palliative Care　Task force for advance care planning in dementia

    2019/01 - Present

  • World Young Leaders in Dementia　Japanese representative

    2014/11 - Present

  • Journal of Alzheimer's Disease　Associate Editor

    2016/01 - 2020/12

  • Kawasaki-shi (special ward in Kanagawa Prefecture)　Council for evaluation on suicide prevention programs

    2015/05 - 2018/03

  • 32nd International Conference of Alzheimer's Disease International　International Advisory Board

    2016/09 - 2017/04

  • The Japanese Association for Mental health　Board of directors

    2012/04 - 2017/03

  • The Japanese Journal of Mental Health　Editorial board member

    2002 - 2017

  • Cabinet Office　Council for evaluation on suicide prevention programs

    2013/08 - 2016/03

  • Japan Association for Clinical Ethics　Counsilor

    2012/10 - 2015/12

  • Cabinet Office　Evaluation team of National fund for urgent project to enhance community-based suicide prevention

    2012/08 - 2013/03

  • 日本精神衛生学会第28回大会　実行委員

    2012/04 - 2012/11

  • 日本精神障害者リハビリテーション学　会第16回大会実行委員

    2008 - 2008/11

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Professional Memberships 3

  • Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment

    2024/01 - Present

  • European Association for Palliative Care

    2022/01 - Present

  • American Psychological Association

    2022/01 - 2023/12

Research Interests 5

  • Mental health services

  • Palliative and end-of-life care

  • Dementia care

  • Health Services Research

  • Health Policy

Research Areas 3

  • Life sciences / Psychiatry /

  • Life sciences / Healthcare management, medical sociology /

  • Life sciences / Hygiene and public health (non-laboratory) /

Awards 5

  1. Award for group contribution

    2022/03　Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government

  2. Award for employee invention

    2018/02　Bureau of Social Welfare and Publich Health, Tokyo Metropolitan Government

  3. The 5th Memorial Award of Late Professor Toshiharu Fujita (Mental Health Statistics)

    2017/02

  4. Recognition Award

    2016/11　Mitsui Sumitomo Insurance Welfare Foundation

  5. Award for oral presentation in the 7th annual meeting of the Japan Association for School Mental Health

    2003/10

Papers 133

  1. Optimizing Advance Care Planning in Dementia: Recommendations from a 33-Country Delphi Study International-journal International-coauthorship Peer-reviewed

    Jenny T. van der Steen, Lieve Van den Block, Miharu Nakanishi, Karen Harrison Dening, Deborah Parker, Phil Larkin, Paola Di Giulio, Jürgen in der Schmitten, Rebecca L. Sudore, Ninoslav Mimica, Iva Holmerova, Sandra Martins Pereira, Ida J. Korfage

    Journal of Pain and Symptom Management　69　(6)　e755-e772　2025/06/01

    Publisher: Elsevier BV

    DOI： 10.1016/j.jpainsymman.2025.02.471 　

    ISSN： 0885-3924

  2. Associations among age at menopause, depressive symptoms, and cognitive function International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Daniel Stanyon, Mitsuhiro Miyashita, Taeko Nakashima, Yuki Miyamoto, Asao Ogawa, Shuntaro Ando, Atsushi Nishida

    Alzheimer's & Dementia　21　(4)　e70063　2025/04/15

    Publisher: Wiley

    DOI： 10.1002/alz.70063 　

    ISSN： 1552-5260

    eISSN： 1552-5279

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    Abstract INTRODUCTION Evidence is scarce regarding the role of menopause in age‐related cognitive function trajectories associated with increased depressive symptoms. We examined the longitudinal association among sex and age at menopause, depressive symptoms, and 2‐year follow‐up cognitive function. METHODS We used data from the English Longitudinal Study of Ageing, classifying age at menopause into three categories: < 40, 40 to 49, and ≥ 50 years. The study included 4726 women and 4286 men, using multilevel panel data regression to depict age trajectories. RESULTS Later menopause (≥ 50 years) was significantly associated with fewer depressive symptoms and better cognition than earlier menopause (< 40 years). Men showed significantly fewer depressive symptoms and worse cognition than women with later menopause. DISCUSSION Earlier menopause was significantly associated with worse 2‐year follow‐up cognition after adjusting for baseline depressive symptoms, cognition, and lifestyle factors. Dementia risk‐reduction strategies should consider women who undergo early menopause as a sex‐specific high‐risk group. Highlights Early menopause is associated with worse depressive symptoms and cognitive function. Early menopause is a high‐risk factor for cognitive decline and depressive symptoms. Menopause at < 40 years is linked to worse orientation and immediate and delayed recall. Men exhibit worse cognitive function than women experiencing late menopause.

  3. Longitudinal associations between subjective cognitive impairment, pain and depressive symptoms in home‐dwelling older adults: Modelling within‐person effects International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Marieke Perry, Rachele Bejjani, Satoshi Yamaguchi, Satoshi Usami, Jenny T. van der Steen

    International Journal of Geriatric Psychiatry　39　(5)　e6103　2024/05/18

    Publisher: Wiley

    DOI： 10.1002/gps.6103 　

    ISSN： 0885-6230

    eISSN： 1099-1166

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    Abstract Objectives Cognitive impairment, pain and depressive symptoms are common and interrelated factors in older adults. However, the directionality and specificity of their association remains unclarified. This study explored whether these factors prospectively increase reciprocal risk and examined the longitudinal association between these factors and quality of life (QoL). Methods This study used longitudinal data from The Older Persons and Informal Caregivers Survey Minimal Data Set (TOPICS‐MDS; the Netherlands). Older adults self‐reported cognitive impairment, pain, depressive symptoms and QoL at baseline and after 6 and 12 months of follow‐up. The Random Intercept Cross‐Lagged Panel Model was used to assess the prospective association between the three factors, while a multilevel linear regression analysis in a two‐level random intercept model was used to examine the longitudinal associations between the three factors and QoL at the within‐person level. Results The data of 11,582 home‐dwelling older adults with or without subjective cognitive impairment were analysed. At the within‐person level, pain at 6 months was associated with subsequent depressive symptoms (β = 0.04, p = 0.024). The reverse association from depression to pain, and longitudinal associations between pain and subjective cognitive impairment and between depressive symptoms and subjective cognitive impairment were non‐significant. Pain, depressive symptoms and subjective cognitive impairment showed a significant association with poor QoL 6 months later. Conclusions A directional relationship was observed from pain to depressive symptoms. Pain reduction holds a potential benefit in the prevention of depressive symptoms, ultimately optimising the QoL of older adults.

  4. Future policy and research for advance care planning in dementia: consensus recommendations from an international Delphi panel of the European Association for Palliative Care International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Sandra Martins Pereira, Lieve Van den Block, Deborah Parker, Karen Harrison-Dening, Paola Di Giulio, Jürgen In der Schmitten, Philip J Larkin, Ninoslav Mimica, Rebecca L Sudore, Iva Holmerová, Ida J Korfage, Jenny T van der Steen, on behalf of the European Association for Palliative Care

    The Lancet Healthy Longevity　5　(5)　e370-e378　2024/05/01

    Publisher: Elsevier BV

    DOI： 10.1016/s2666-7568(24)00043-6 　

    ISSN： 2666-7568

  5. Consensus definition of advance care planning in dementia: A 33‐country Delphi study International-journal International-coauthorship Peer-reviewed

    Jenny T. van der Steen, Miharu Nakanishi, Lieve Van den Block, Paola Di Giulio, Silvia Gonella, Jürgen in der Schmitten, Rebecca L. Sudore, Karen Harrison Dening, Deborah Parker, Ninoslav Mimica, Iva Holmerova, Philip Larkin, Sandra Martins Pereira, Judith A. C. Rietjens, Ida J. Korfage

    Alzheimer's & Dementia　20　(2)　1309-1320　2024/02/21

    DOI： 10.1002/alz.13526 　

  6. Interventions that may increase control at the end of life in persons with dementia: the cross-cultural CONT-END acceptability study protocol and pilot-testing International-journal International-coauthorship

    Hanneke J.A. Smaling, Xu Jingyuan, Miharu Nakanishi, Shiri Shinan-Altman, David R. Mehr, Lukas Radbruch, Jan Gaertner, Perla Werner, Wilco P. Achterberg, Jenny T. van der Steen

    BMC Palliative Care　22　(1)　2023/09/27

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s12904-023-01249-7 　

    eISSN： 1472-684X

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    Abstract Background Interventions such as advance care planning (ACP), technology, or access to euthanasia may increase the sense of control over the end of life. In people with advanced dementia, the loss of cognitive and physical function limits the ability to control care. To date, little is known about the acceptability of these interventions from the perspective of persons with dementia and others involved. This study will examine the cross-cultural acceptability, and factors associated with acceptability, of four end-of-life interventions in dementia which contain an element of striving for control. Also, we report on the development and pilot testing of animation video vignettes that explain the interventions in a standardized manner. Methods Cross-sectional mixed-methods vignette study. We assess acceptability of two ACP approaches, technology use at the end of life and euthanasia in persons with dementia, their family caregivers and physicians in six countries (Netherlands, Japan, Israel, USA, Germany, Switzerland). We aim to include 80 participants per country, 50 physicians, 15 persons with dementia, and 15 family caregivers. After viewing each animation video, participants are interviewed about acceptability of the intervention. We will examine differences in acceptability between group and country and explore other potentially associated factors including variables indicating life view, personality, view on dementia and demographics. In the pilot study, participants commented on the understandability and clarity of the vignettes and instruments. Based on their feedback, the scripts of the animation videos were clarified, simplified and adapted to being less slanted in a specific direction. Discussion In the pilot study, the persons with dementia, their family caregivers and other older adults found the adapted animation videos and instruments understandable, acceptable, feasible, and not burdensome. The CONT-END acceptability study will provide insight into cross-cultural acceptability of interventions in dementia care from the perspective of important stakeholders. This can help to better align interventions with preferences. The study will also result in a more fundamental understanding as to how and when having control at the end of life in dementia is perceived as beneficial or perhaps harmful. Trial registration The CONT-END acceptability study was originally registered at the Netherlands Trial Register (NL7985) at 31 August, 2019, and can be found on the International Clinical Trials Registry Platform.

  7. Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study International-journal International-coauthorship Peer-reviewed

    Helma M F Verstraeten, Canan Ziylan, Debby L Gerritsen, Robbert Huijsman, Miharu Nakanishi, Martin Smalbrugge, Jenny T van der Steen, Sytse U Zuidema, Wilco P Achterberg, Ton J E M Bakker

    JMIR Research Protocols　11　(6)　e34550-e34550　2022/06/22

    Publisher: {JMIR} Publications Inc.

    DOI： 10.2196/34550 　

    ISSN： 1929-0748

    eISSN： 1929-0748

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    Background Neuropsychiatric symptoms occur frequently in many nursing home residents with dementia. Despite the availability of multidisciplinary guidelines, neuropsychiatric symptoms are often inadequately managed. Three proven effective methods for managing neuropsychiatric symptoms were integrated into a single intervention method: the STIP-Method, a personalized integrated stepped-care method to prevent and treat neuropsychiatric symptoms. The STIP-Method comprises 5 phases of clinical reasoning to neuropsychiatric symptoms and 4 stepped-care interventions and is supported with a web application. Objective This study aims to identify the facilitators and barriers in the implementation of the STIP-Method in nursing homes. Methods A mixed methods design within a participatory action research was used to implement the STIP-Method in 4 facilities of 2 Dutch nursing home organizations. In total, we aimed at participation of 160-200 persons with dementia and expected an intervention fidelity of 50% or more, based on earlier studies regarding implementation of effective psychosocial interventions to manage neuropsychiatric symptoms. All involved managers and professionals were trained in the principles of the STIP-Method and in using the web application. An advisory board of professionals, managers, and informal caregivers in each facility supported the implementation during 21 months, including an intermission of 6 months due to the COVID-19 pandemic. In these 6-weekly advisory board meetings, 2 researchers stimulated the members to reflect on progress of the implementation by making use of available data from patient records and the web application. Additionally, the 2 researchers invited the members to suggest how to improve the implementation. Data analysis will involve (1) analysis of facilitators and barriers to the implementation derived from verbatim text reports of advisory board meetings to better understand the implementation process; (2) analysis of patient records in accordance with multidisciplinary guidelines to neuropsychiatric symptoms: personalized, interdisciplinary, and proactive management of neuropsychiatric symptoms; (3) evaluation of the web application in terms of usability scores; (4) pre- and postimplementation analysis of patient records and the web application to evaluate the impact of the STIP-Method, such as changes in neuropsychiatric symptoms and informal caregiver burden. Results We enrolled 328 persons with dementia. Data collection started in July 2019 and ended in December 2021. The first version of this manuscript was submitted in October 2021. The first results of data analysis are expected to be published in December 2022 and final results in June 2023. Conclusions Our study may increase understanding of facilitators and barriers to the prevention and treatment of neuropsychiatric symptoms in nursing home residents with dementia by implementing the integrated STIP-Method. The need for well-designed implementation studies is of importance to provide nursing homes with optimal tools to prevent and treat neuropsychiatric symptoms. International Registered Report Identifier (IRRID) DERR1-10.2196/34550

  8. Adolescent Carers' Psychological Symptoms and Mental Well-being During the COVID-19 Pandemic: Longitudinal Study Using Data From the UK Millennium Cohort Study International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Marcus Richards, Daniel Stanyon, Syudo Yamasaki, Kaori Endo, Mai Sakai, Hatsumi Yoshii, Atsushi Nishida

    Journal of Adolescent Health　70　(6)　877-884　2022/05/18

    Publisher: Elsevier BV

    DOI： 10.1016/j.jadohealth.2022.01.228 　

    ISSN： 1054-139X

  9. Japanese National Dementia Plan Is Associated with a Small Shift in Location of Death: An Interrupted Time Series Analysis International-journal International-coauthorship Peer-reviewed

    Joost D. Wammes, Miharu Nakanishi, Jenny T. van der Steen, Janet L. MacNeil Vroomen

    Journal of Alzheimer's Disease　83　(2)　791-797　2021/09/14

    Publisher: IOS Press

    DOI： 10.3233/jad-210521 　

    ISSN： 1387-2877

    eISSN： 1875-8908

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    Background: Japan has one of the highest percentages of persons with dementia and hospital deaths in the world. Hospitals are often not equipped to handle the care complexity required for persons with dementia at the end of life. The National Dementia Orange plan aimed to decrease hospital deaths by expanding time in the community. Objective: The aim of this study is to evaluate whether the National Dementia Orange Plan is associated with a decrease in hospitals deaths for persons with dementia. Methods: We used quarterly, cross-sectional, national death certificate data consisting of the total Japanese dementia population 65 years and older, spanning a period from 2009 to 2016. The primary outcome was quarterly adjusted relative risk rates (aRRR) of dying in hospital, nursing home, home, or elsewhere. An interrupted time series analysis was performed to study the slope change over time. Analyses were adjusted for sex and seasonality. Results: 149,638 died with dementia. With the implementation of the Orange Plan, death in nursing home (aRRR 1.08, [1.07–1.08], p < 0.001) and elsewhere (aRRR 1.05, [1.05–1.06], p < 0.001) increased over time compared to hospital death. No changes were found in death at home. Conclusion: This study provides evidence that the National Dementia Orange plan was associated with a small increase in death in nursing home and elsewhere. Hospital death remained the primary location of death. End-of-life strategies should be expanded in national dementia policies to increase aging in the community until death.

  10. National dementia plans to address escalating global palliative care needs International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Jenny T. van der Steen

    Palliative Medicine　34　(7)　966-967　2020/07/01

    Publisher: {SAGE} Publications

    DOI： 10.1177/0269216320913466 　

  11. An evaluation of palliative care contents in national dementia strategies in reference to the European Association for Palliative Care white paper International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Yumi Shindo, Yuki Miyamoto, Dianne Gove, Lukas Radbruch, Jenny T. van der Steen

    International Psychogeriatrics　27　(9)　1551-1561　2015/02/13

    DOI： 10.1017/s1041610215000150 　

    ISSN： 1041-6102

    eISSN： 1741-203X

  12. Educating families about end-of-life care in advanced dementia: Acceptability of a Canadian family booklet to nurses from Canada, France, and Japan International-journal International-coauthorship Peer-reviewed

    Marcel Arcand, Kevin Brazil, Miharu Nakanishi, Taeko Nakashima, Michel Alix, Jean-François Desson, Rémy Morello, Louise Belzile, Marie Beaulieu, Cees M.P.M. Hertogh, Franco Toscani, Jenny T Van Der Steen

    International Journal of Palliative Nursing　19　(2)　67-74　2013/02/01

    Publisher: MA Healthcare Ltd

    DOI： 10.12968/ijpn.2013.19.2.67 　

    ISSN： 1357-6321

  13. Translation and cross-cultural adaptation of a family booklet on comfort care in dementia: sensitive topics revised before implementation International-journal International-coauthorship Peer-reviewed

    Jenny T. van der Steen, Cees M. P. M. Hertogh, Tjomme de Graas, Miharu Nakanishi, Franco Toscani, Marcel Arcand

    JOURNAL OF MEDICAL ETHICS　39　(2)　104-109　2013/02/01

    DOI： 10.1136/medethics-2012-100903 　

    ISSN： 0306-6800

  14. A Family Booklet About Comfort Care in Advanced Dementia: Three-Country Evaluation International-journal International-coauthorship Peer-reviewed

    Jenny T. van der Steen, Marcel Arcand, Franco Toscani, Tjomme de Graas, Silvia Finetti, Marie Beaulieu, Kevin Brazil, Miharu Nakanishi, Taeko Nakashima, Dirk L. Knol, Cees M. P. M. Hertogh

    JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION　13　(4)　368-375　2012/05/01

    DOI： 10.1016/j.jamda.2011.02.005 　

    ISSN： 1525-8610

    eISSN： 1538-9375

  15. Physicians' and Nurses' Perceived Usefulness and Acceptability of a Family Information Booklet about Comfort Care in Advanced Dementia International-journal International-coauthorship Peer-reviewed

    Jenny T. van der Steen, Franco Toscani, Tjomme de Graas, Silvia Finetti, Miharu Nakanishi, Taeko Nakashima, Kevin Brazil, Cees M. P. M. Hertogh, Marcel Arcand

    JOURNAL OF PALLIATIVE MEDICINE　14　(5)　614-622　2011/05/19

    DOI： 10.1089/jpm.2010.0484 　

    ISSN： 1096-6218

    eISSN： 1557-7740

  16. Investigating the association between the number of interpersonal supporters during first-time pregnancy and postpartum depression symptoms International-journal International-coauthorship Peer-reviewed

    Junko Niimura, Syudo Yamasaki, Miharu Nakanishi, Satoshi Yamaguchi, Kaori Baba, Naomi Nakajima, Mitsuhiro Miyashita, Daniel Stanyon, Gemma Knowles, Jordan DeVylder, Mariko Hiraiwa-Hasegawa, Shuntaro Ando, Kiyoto Kasai, Atsushi Nishida

    Epidemiology and Psychiatric Sciences　34　e34　2025/06/27

    Publisher: Cambridge University Press (CUP)

    DOI： 10.1017/s2045796025000241 　

    ISSN： 2045-7960

    eISSN： 2045-7979

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    Abstract Aims First-year postpartum depression is a common mental health problem among first-time mothers. A younger age of pregnancy often compounds the challenge due to underlying factors such as poverty and limited educational achievement. This study aimed to examine the minimal number of interpersonal supporters during pregnancy associated with lower levels of postpartum depressive symptoms among first-time mothers. Methods We obtained data from the population-based Mother–Infant/Newborn Tokyo Cohort (MINT cohort) in four municipalities in Tokyo on 429 first-time mothers who responded to two waves of surveys (early pregnancy and one month postpartum). They completed self-report measures of interpersonal support using one item from the Social Support Questionnaire and depressive symptoms using the Edinburgh Postnatal Depression Scale. Segmented regression analyses were conducted to determine the threshold at which the strength of the association changed between the number of interpersonal supporters and postpartum depressive symptoms, with adjustment for depressive symptoms in pregnancy. This analysis was also conducted with the sample stratified into young mothers (≤ 25 years) and older mothers (≥ 26 years). Results In the overall sample, postpartum depressive symptoms were found to be lower among individuals with more than 3.0 supportive individuals (prepartum). Among young mothers, this threshold was higher, with lower symptom levels observed among those with at least 5.3 supporters. Only 22.9% of young first-time mothers had this level of interpersonal support, compared to 54.8% of all first-time mothers. Conclusions Our results suggest that having four or more interpersonal supporters in early pregnancy is associated with lower levels of postpartum depressive symptoms among first-time mothers. Additionally, among young mothers, having six or more supporters was associated with lower postpartum depressive symptoms. These findings suggest that tailored strategies to increase supporters around first-time pregnant women might be beneficial depending on their age.

  17. Factors Influencing Foreign-Born Care Workers’ Acceptance in Residential Care Facilities in Japan: Work and Organizational Characteristics, Work Conditions, Job Stress, and Work Environment International-journal Peer-reviewed

    Maki Tei-Tominaga, Miharu Nakanishi, Masae Tanaka

    Journal of Applied Gerontology　2025/06/24

    Publisher: SAGE Publications

    DOI： 10.1177/07334648251353261 　

    ISSN： 0733-4648

    eISSN： 1552-4523

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    Japan, a super-aging society, faces a native care worker shortage and increased demand for foreign-born care workers (FBCWs) in geriatric care facilities. We investigated factors influencing native care workers’ concerns and reluctance toward accepting FBCWs in Japan from four areas. Native care workers ( N = 1060) in 10 geriatric care facilities (response rate = 71%), recruited using convenience sampling considering the regional job vacancies, responded to a self-report questionnaire survey. After excluding ineligible data (e.g., for day-care facilities) or missing data, the analysis included 589 participants (67.2% women, M age = 42.63 ± 12.16 years). Results indicated that facilities not accepting FBCWs had significant concerns about managerial positions and job stress. Native care workers with concerns about accepting FBCWs and those working 50+ hours per week were three times more reluctant to accept FBCWs. However, ethical leadership reduced this reluctance. Therefore, facility employers in aging countries must address native care workers’ concerns and ensure workplace improvement before hiring FBCWs.

  18. Experimenters' sex modulates anxiety-like behavior, contextual fear, and microglial oxytocin transcription in mice International-journal International-coauthorship Peer-reviewed

    Mai Sakai, Zhiqian Yu, Rosanne Picotin, Tomoko Kasahara, Yoshie Kikuchi, Chiaki Ono, Mizuki Hino, Yasuto Kunii, Yuko Maejima, Kenju Shimomura, Miharu Nakanishi, Takaaki Abe, Hatsumi Yoshii, Hiroaki Tomita

    Behavioural Brain Research　483　115480　2025/04/12

    Publisher: Elsevier BV

    DOI： 10.1016/j.bbr.2025.115480 　

    ISSN： 0166-4328

  19. Concept of good death in people with dementia: a cross‐sectional questionnaire survey of bereaved family members and medical professionals International-journal Peer-reviewed

    Mitsunori Miyashita, Mizuho Nonaka, Maho Aoyama, Miharu Nakanishi, Miyae Yamakawa, Hiroki Fukahori, Kazuki Sato, Zaiya Takahashi, Hiroko Nagae, Tatsuya Morita

    Psychogeriatrics　25　(2)　e70015　2025/02/26

    Publisher: Wiley

    DOI： 10.1111/psyg.70015 　

    ISSN： 1346-3500

    eISSN： 1479-8301

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    Abstract Background There is limited quantitative evidence regarding good death for people with dementia. Aims To clarify which components of good death are important for people with dementia and to identify the component structure of good death through explanatory factor analysis. Design A web‐based questionnaire survey was conducted where bereaved family members and professionals were asked to rate the importance of the 44 items identified from previous qualitative interviews as components of ‘good death’. Setting/participants A total of 618 bereaved family members of people with dementia, and 206 physicians, nurses and care workers, each, involved in dementia care. Results A total of 1236 participant responses were analyzed. The exploratory factor analysis identified the following four factors as the concepts of good death for people with dementia: ‘Comfort, security, and safety’, ‘Relationships’, ‘Independence’, and ‘Personhood care’. The top five items that bereaved families indicated as important were ‘dying at peace’ (97%), ‘being free from pain and physical distress’ (97%), ‘being calm’ (96%), ‘being clean’ (96%), and ‘receiving necessary daily living assistance’ (96%). The items with the lowest scores were ‘being cared for by family’ (53%), ‘living with faith’ (54%), and ‘remaining in people's memory after one's death’ (67%). We found only small differences between the opinions of the bereaved family members and medical professionals. Conclusions The components of good death which stakeholders consider important provide useful information for developing care implementation strategies for dying people with dementia.

  20. Longitudinal associations between informal caring, social network, and psychological distress among adolescents and young adults: modelling within-person effects Peer-reviewed

    Miharu Nakanishi, Satoshi Yamaguchi, Mai Sakai, Hatsumi Yoshii, Syudo Yamasaki, Atsushi Nishida, Takahiro Tabuchi

    BMC Public Health　25　260　2025/01/22

    DOI： 10.1186/s12889-025-21514-z 　

    ISSN： 1471-2458

  21. Association between self‐stigma and self‐compassion in patients with schizophrenia: A longitudinal study from hospital admission to first follow‐up after discharge International-journal Peer-reviewed

    Keita Toshi, Miharu Nakanishi, Mai Sakai, Hatsumi Yoshii

    Japan Journal of Nursing Science　22　(1)　e12648　2025/01/15

    DOI： 10.1111/jjns.12648 　

  22. Association between previous work experience in general healthcare and recovery orientation among mental health professionals during the COVID-19 pandemic in Japan International-journal Invited Peer-reviewed

    Miharu Nakanishi, Tomohiro Takahashi, Keita Toshi, Mai Sakai, Hatsumi Yoshii

    Discover Global Society　3　3　2025/01/13

    DOI： 10.1007/s44282-024-00133-w 　

  23. Development and effectiveness of an educational program to foster psychological safety: A randomized controlled trial focusing on care workers in geriatric care facilities International-journal Peer-reviewed

    Maki Tei-Tominaga, Miharu Nakanishi, Masae Tanaka

    Geriatric Nursing　61　162-168　2025/01/01

    DOI： 10.1016/j.gerinurse.2024.10.065 　

  24. Association of Problematic Internet Use With Psychotic Experiences and Depression in Adolescents: A Cohort Study International-journal International-coauthorship Peer-reviewed

    Zui Narita, Shuntaro Ando, Syudo Yamasaki, Mitsuhiro Miyashita, Jordan DeVylder, Satoshi Yamaguchi, Mariko Hosozawa, Miharu Nakanishi, Mariko Hiraiwa-Hasegawa, Toshiaki A Furukawa, Kiyoto Kasai, Atsushi Nishida

    Schizophrenia Bulletin　51　(1)　198-207　2025/01/01

    Publisher: Oxford University Press (OUP)

    DOI： 10.1093/schbul/sbae089 　

    ISSN： 0586-7614

    eISSN： 1745-1701

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    Abstract Background and Hypothesis Problematic internet use (PIU) is prevalent among adolescents. Past research suggested cross-sectional associations between PIU and psychotic experiences, but little information is available on the longitudinal association. We hypothesized that PIU in adolescence may be longitudinally associated with psychotic experiences, adjusting for confounders. Study Design We analyzed a random sample of adolescents in the Tokyo Teen Cohort to examine how PIU at ages 10 (2012–2015), 12 (2014–2017), and 16 (2019–2021) was associated with mental health issues at age 16. PIU was evaluated by the modified Compulsive Internet Use Scale, psychotic experiences by the Adolescent Psychotic-like Symptom Screener, and depression by the Short Mood and Feelings Questionnaire. We also examined the mediating role of social withdrawal. Study Results We analyzed 3171 adolescents; 151 reported psychotic experiences and 327 reported depression at age 16. Compared with the lowest tertile PIU group, the highest tertile PIU group at age 12 showed an increased adjusted risk of psychotic experiences (RD 3.3%, 95% CI 2.9%–3.7%; RR 1.65, 95% CI 1.55–1.73) and depression (RD 5.9%, 95% CI 5.5%–6.3%; RR 1.61, 95% CI 1.55–1.68) at age 16. PIU at age 16 showed analogous results, while PIU at age 10 suggested a smaller impact. Social withdrawal mediated 9.4%–29.0% of the association between PIU and psychotic experiences. Conclusions PIU is longitudinally associated with psychotic experiences and depression in adolescents. Further longitudinal and intervention studies are warranted to provide robust public health implications and foster a safer digital future.

  25. How international experts would define advance care planning: a content analysis International-journal International-coauthorship Peer-reviewed

    Jenny T. van der Steen, Emma J. de Wit, Mandy Visser, Miharu Nakanishi, Lieve Van den Block, Ida J. Korfage, Jürgen in der Schmitten, Rebecca L. Sudore

    Annals of Palliative Medicine　13　(6)　1409-1419　2024/11/30

    Publisher: AME Publishing Company

    DOI： 10.21037/apm-24-57 　

    ISSN： 2224-5820

    eISSN： 2224-5839

  26. Investigating the Differential Impact of Short- and Long-Term Informal Caregiving on Mental Health Across Adolescence: Data From the Tokyo Teen Cohort International-journal International-coauthorship Peer-reviewed

    Daniel Stanyon, Miharu Nakanishi, Syudo Yamasaki, Mitsuhiro Miyashita, Satoshi Yamaguchi, Kaori Baba, Naomi Nakajima, Junko Niimura, Jordan DeVylder, Mariko Hiraiwa-Hasegawa, Shuntaro Ando, Kiyoto Kasai, Atsushi Nishida

    Journal of Adolescent Health　75　(4)　642-649　2024/10/01

    DOI： 10.1016/j.jadohealth.2024.06.005 　

  27. Glial Markers of Suicidal Behavior in the Human Brain—A Systematic Review of Postmortem Studies International-journal Peer-reviewed

    Mana Yamamoto, Mai Sakai, Zhiqian Yu, Miharu Nakanishi, Hatsumi Yoshii

    International Journal of Molecular Sciences　25　(11)　5750　2024/05/25

    DOI： 10.3390/ijms25115750 　

  28. 統合失調症を有する入院中の患者の自己効力感や自尊感情と自覚的なストレングスの数、相談できる人の数との関連性について Peer-reviewed

    光永憲香, 竹村涼音, 中西三春, 坂井舞, 大室則幸

    日本看護学会誌　19　(1)　16-21　2024/05/01

  29. Sex Differences in Adolescent Depression Trajectory Before and Into the Second Year of COVID-19 Pandemic International-journal International-coauthorship Peer-reviewed

    Mariko Hosozawa, Shuntaro Ando, Satoshi Yamaguchi, Syudo Yamasaki, Jordan DeVylder, Mitsuhiro Miyashita, Kaori Endo, Daniel Stanyon, Gemma Knowles, Miharu Nakanishi, Satoshi Usami, Hiroyasu Iso, Toshi A. Furukawa, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Journal of the American Academy of Child & Adolescent Psychiatry　63　(5)　539-548　2024/05/01

    Publisher: Elsevier BV

    DOI： 10.1016/j.jaac.2023.08.016 　

    ISSN： 0890-8567

  30. Association Between Dementia, Change in Home-Care Use, and Depressive Symptoms During the COVID-19 Pandemic: A Longitudinal Study Using Data from Three Cohort Studies International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Taeko Nakashima, Yuki Miyamoto, Claudia Cooper, Marcus Richards, Daniel Stanyon, Mai Sakai, Hatsumi Yoshii, Atsushi Nishida

    Journal of Alzheimer's Disease　99　(1)　403-415　2024/04/30

    Publisher: IOS Press

    DOI： 10.3233/jad-240097 　

    ISSN： 1387-2877

    eISSN： 1875-8908

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    Background: The emotional impact of the coronavirus disease 2019 (COVID-19) pandemic on people with dementia has been quantified. However, little is known about the impact of change in home-care use owing to the pandemic. Objective: To determine the longitudinal association between dementia, change in home-care use, and depressive symptoms during the pandemic. Methods: We included data of 43,782 home-dwelling older adults from the English Longitudinal Study of Ageing (ELSA), Study of Health, Ageing and Retirement in Europe (SHARE), and National Health and Aging Trends Study (NHATS). This study considered the latest main wave survey prior to the pandemic as the baseline, and the COVID-19 survey as follow-up. In a series of coordinated analyses, multilevel binomial logistic regression model was used to examine the association between baseline dementia, change in home-care use at follow-up, and presence of depressive symptoms. Results: Dementia, using the ELSA, SHARE, and NHATS datasets, was identified in 2.9%, 2.3%, and 6.5% of older adults, and home-care use reduced in 1.7%, 2.8%, and 1.1% of individuals with dementia, respectively. Dementia was significantly associated with the increased risk of depressive symptoms in all three cohorts. However, the interaction between dementia and period (follow-up) was non-significant in SHARE and NHATS. Across all three cohorts, home-care use during the pandemic, regardless of change in amount, was significantly associated with increased depressive symptoms, compared to the non-use of home care. Conclusions: These results highlight the need for tailoring dementia care at home to promote independence and provide sustainable emotional support.

  31. A palliative care goals model for people with dementia and their family: Consensus achieved in an international Delphi study International-journal International-coauthorship Peer-reviewed

    Mayumi Nishimura, Karen Harrison Dening, Elizabeth L. Sampson, Edison Iglesias de Oliveira Vidal, Miharu Nakanishi, Nathan Davies, Wilson Abreu, Sharon Kaasalainen, Yvonne Eisenmann, Laura Dempsey, Kirsten J. Moore, Sascha R. Bol, Judith M.M. Meijers, Natashe Lemos Dekker, Mitsunori Miyashita, Takeo Nakayama, Jenny T. van der Steen

    Palliative Medicine　in press　2024/04/18

    DOI： 10.1177/02692163241234579 　

  32. What are best practices for involving family caregivers in interventions aimed at responsive behaviour stemming from unmet needs of people with dementia in nursing homes: a scoping review International-journal International-coauthorship Peer-reviewed

    Petra E M Tasseron-Dries, Hanneke J A Smaling, Miharu Nakanishi, Wilco P Achterberg, Jenny T van der Steen

    BMJ Open　13　(12)　e071804-e071804　2023/12/07

    Publisher: BMJ

    DOI： 10.1136/bmjopen-2023-071804 　

    ISSN： 2044-6055

    eISSN： 2044-6055

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    Objectives This study aimed to determine best practices for involving family caregivers in interventions aimed at preventing and reducing responsive behaviour stemming from unmet needs, including pain. Design Scoping review, reported according to the Preferred Reporting Items for Systematic Reviews, Meta-Analyses extension for Scoping Reviews reporting guideline. Data sources PubMed, Embase, Emcare, Web of Science, COCHRANE Library, PsycINFO, Academic Search Premier and Cinahl searched up to 23 July 2023. Eligibility criteria Studies reporting on family involvement in interventions for nursing home residents with dementia were included. Data extraction and synthesis Two researchers independently extracted the data, followed by a content analysis. Results Of the 1486 records screened, 20 studies were included. Family caregivers were involved in interventions aimed at planning care, life review (eg, documentation of life experiences of their relative), and selecting activities for their relative. Family caregivers preferred an active role in developing optimal care for their relative. Drivers of success and barriers to family involvement centred around three themes: (1) communication between all involved; (2) prerequisites (organisational and other conditions) and (3) personal circumstances (family’s coping and skills). Conclusion Best practices for involving family caregivers in interventions aimed at addressing responsive behaviour in residents with dementia concerned those interventions in which family caregivers were given an important role in managing responsive behaviour. This means that, in order to achieve an active role of family caregivers in the whole care process, their needs must be taken into account. Trial registration number The protocol of the review was regisered at OSF;https://osf.io/twcfq

  33. Association between menopause and suicidal ideation in mothers of adolescents: A longitudinal study using data from a population-based cohort International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Kaori Endo, Syudo Yamasaki, Daniel Stanyon, Sarah Sullivan, Satoshi Yamaguchi, Shuntaro Ando, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida, Mitsuhiro Miyashita

    Journal of Affective Disorders　340　529-534　2023/11/01

    Publisher: Elsevier BV

    DOI： 10.1016/j.jad.2023.08.055 　

    ISSN： 0165-0327

  34. Rehospitalisation rates after long-term follow-up of patients with severe mental illness admitted for more than one year: A systematic review International-journal Peer-reviewed

    Sayaka Sato, Miharu Nakanishi, Makoto Ogawa, Makiko Abe, Naonori Yasuma, Toshiaki Kono, Momoka Igarashi, Mai Iwanaga, Takayuki Kawaguchi, Sosei Yamaguchi

    BMC Psychiatry　23　(1)　788-788　2023/10/27

    DOI： 10.1186/s12888-023-05290-x 　

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    AIMS: This study aimed to conduct a systematic review of studies on the outcomes of long-term hospitalisation of individuals with severe mental illness, considering readmission rates as the primary outcome. METHODS: Studies considered were those in which participants were aged between 18 and 64 years with severe mental illness; exposure to psychiatric hospitals or wards was long-term (more than one year); primary outcomes were readmission rates; secondary outcomes were duration of readmission, employment, schooling, and social participation; and the study design was either observational or interventional with a randomised controlled trial (RCT) design. Relevant studies were searched using MEDLINE, PsycINFO, Web of Science, CINAHL, and the Japan Medical Abstract Society. The final search was conducted on 1 February 2022. The risk of bias in non-randomised studies of interventions was used to assess the methodological quality. A descriptive literature review is also conducted. RESULTS: Of the 11,999 studies initially searched, three cohort studies (2,293 participants) met the eligibility criteria. The risk of bias in these studies was rated as critical or serious. The 1-10 years readmission rate for patients with schizophrenia who had been hospitalised for more than one year ranged from 33 to 55%. The average of readmission durations described in the two studies was 70.5 ± 95.6 days per year (in the case of a 7.5-year follow-up) and 306 ± 399 days (in the case of a 3-8-year follow-up). None of the studies reported other outcomes defined in this study. CONCLUSIONS: The readmission rates in the included studies varied. Differences in the follow-up period or the intensity of community services may have contributed to this variability. In countries preparing to implement de-institutionalisation, highly individualised community support should be designed to avoid relocation to residential services under supervision. The length of stay for readmissions was shorter than that for index admissions. The results also imply that discharge to the community contributes to improved clinical outcomes such as improved social functioning. The validity of retaining patients admitted because of the risk of rehospitalisation was considered low. Future research directions have also been discussed.

  35. Development of a Scale to Assess the Psychosocial Work Environment of Hospital Nurses: The Social Capital and Ethical Climate at the Workplace Peer-reviewed

    Maki Tei-Tominaga, Miharu Nakanishi

    Journal of Japanese Society for International Nursing　7　(2)　1-11　2023/10/02

    DOI： 10.57321/jsin.20230724 　

    ISSN： 2434-1444 2434-1452

  36. Longitudinal relationships between help-seeking intentions and depressive symptoms in adolescents International-journal International-coauthorship Peer-reviewed

    Satoshi Yamaguchi, Shuntaro Ando, Satoshi Usami, Syudo Yamasaki, Kaori Endo, Jordan DeVylder, Daniel Stanyon, Kaori Baba, Naomi Nakajima, Junko Niimura, Miharu Nakanishi, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Journal of Adolescent Health　in press　2023/09/04

    Publisher: Elsevier BV

    DOI： 10.1016/j.jadohealth.2023.06.033 　

    ISSN： 1054-139X

  37. Place of death from dementia as an underlying cause during the COVID-19 pandemic in Japan: a cross-sectional study from national death certificates International-journal Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Mai Sakai, Hatsumi Yoshii, Asao Ogawa, Atsushi Nishida

    Palliative Care and Social Practice　17　26323524231193039　2023/08/28

    Publisher: SAGE Publications

    DOI： 10.1177/26323524231193039 　

    ISSN： 2632-3524

    eISSN： 2632-3524

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    Background: The coronavirus disease (COVID-19) pandemic has challenged palliative end-of-life care for people with dementia. The site of death can be considered as an end-of-life care quality indicator. Most people with dementia prefer to die at nursing or private homes; however, in Japan, they are often hospitalized in psychiatric hospitals for management of neuropsychiatric symptoms. As palliative end-of-life care for older adults with Alzheimer’s disease and related dementias has been further challenged by the COVID-19 pandemic, little is known about its effects on the place of death in patients with dementia. Objectives: This study aimed to investigate the shifts in place of death from dementia during the COVID-19 pandemic in Japan. Changes throughout the pandemic were compared between deaths from dementia and from senility. Design: Cross-sectional. Methods: Death certificate data of individuals aged 65 years or older who died in Japan between 1 January 2018, and 31 December 2021, were used to extract the cause and place of death. Differences in place of death between the periods were estimated using multinomial logistic analysis with reference to death in private homes. Results: Deaths from dementia mostly occurred in hospitals (59%), while deaths from senility were most frequent in nursing homes (37%). After adjusting for patient characteristics, the likelihood of hospital deaths significantly increased for patients with dementia during the pandemic. Meanwhile, the likelihood of senility deaths decreased in hospitals but increased in nursing homes during the pandemic. Conclusion: The shift to hospital deaths since the onset of the COVID-19 pandemic was uniquely observed in deaths from dementia. This hospital shift likely involved increased transfers from nursing and private homes to psychiatric hospitals. Further investigation is needed to examine the association between the pandemic-related change in long-term care workforce and palliative care practice in people with dementia.

  38. Informal caregiving in adolescents from 10 to 16 years old: A longitudinal study using data from the Tokyo Teen Cohort International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Daniel Stanyon, Marcus Richards, Syudo Yamasaki, Shuntaro Ando, Kaori Endo, Mariko Hosozawa, Mitsuhiro Miyashita, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    International Journal of Environmental Research and Public Health　20　(15)　6482-6482　2023/07/31

    Publisher: MDPI AG

    DOI： 10.3390/ijerph20156482 　

    eISSN： 1660-4601

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    There is growing evidence of the impact of informal caregiving on adolescent mental health, and its role is often hidden unintentionally or intentionally, which may hamper early identification and support for young informal caregivers. However, the quantitative evidence regarding household factors relating to informal caregiving has mostly been based on cross-sectional findings. This study examines the longitudinal associations between household characteristics and the duration of informal caregiving in adolescents from 10 to 16 years of age. Child–household respondent pairs (n = 2331) from the Tokyo Teen Cohort in Japan were followed every 2 years from 10 to 16 years of age. Informal caregiving was assessed repeatedly based on the household respondent’s survey responses. Persistent caregiving was defined as daily caregiving at two or more waves. There were 2.2% of children who gave daily care at two or more waves. Cross-sectional associations with daily informal caregiving at each wave were found with girls, low household income, and cohabiting with grandparents. A significant association with persistent caregiving was found only in cohabiting with grandparents at 10 years of age after adjusting for sex, number of siblings, single parent, and household income. Our longitudinal examination highlighted cohabiting with grandparents as a preceding factor for persistent caregiving. Identification and support for young informal caregivers should be integrated into social care service systems for older adults. The mechanism of persistent caregiving requires clarification.

  39. Quality of End-of-Life Care for Older Adults with Dementia During COVID-19 Pandemi International-journal Peer-reviewed

    Miharu Nakanishi, Asao Ogawa, Mai Sakai, Hatsumi Yoshii, Syudo Yamasaki, Atsushi Nishida

    Journal of the American Medical Directors Association　24　(6)　906-910.e2　2023/05/29

    Publisher: Elsevier BV

    DOI： 10.1016/j.jamda.2023.03.001 　

    ISSN： 1525-8610

  40. Depression and Anxiety in Older Adults with Dementia During the COVID-19 Pandemic International-journal Peer-reviewed

    Miharu Nakanishi, Asao Ogawa, Mai Sakai, Hatsumi Yoshii, Mitsuhiro Miyashita, Syudo Yamasaki, Atsushi Nishida

    Journal of Alzheimer's Disease Reports　7　(1)　307-315　2023/04/12

    Publisher: IOS Press

    DOI： 10.3233/adr-230019 　

    eISSN： 2542-4823

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    This study examined the longitudinal association between dementia, activity participation, the coronavirus disease 2019 pandemic period, and 1-year mental health changes. We obtained data from the National Health and Aging Trends Study in the United States. We included 4,548 older adult participants of two or more survey rounds between 2018 and 2021. We identified baseline dementia status, and assessed depressive symptoms and anxiety at baseline and follow-up. Dementia and poor activity participation were independently associated with an increased prevalence of depressive symptoms and anxiety. Dementia care and support should address emotional and social needs under continued public health restrictions.

  41. Association Between Advance Care Planning and Depressive Symptoms Among Community-Dwelling People With Dementia: An Observational Cross-Sectional Study During The COVID-19 Pandemic in Japan International-journal Invited Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Yuki Miyamoto, Mai Sakai, Hatsumi Yoshii, Syudo Yamasaki, Atsushi Nishida

    Frontiers in Public Health　11　915387　2023/03/30

    Publisher: Frontiers Media SA

    DOI： 10.3389/fpubh.2023.915387 　

    eISSN： 2296-2565

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    Objectives Advance care planning (ACP) is an increasing priority for people with dementia during the COVID-19 pandemic. This study evaluated the association between ACP initiation and depressive symptoms among home-dwelling people living with dementia. Methods An internet-based questionnaire survey was conducted with Japanese family caregivers of home-dwelling persons with dementia in June 2021. Family caregivers evaluated the level of depressive symptoms in persons with dementia using the Neuropsychiatric Inventory (NPI). Caregivers also rated the quality of life of persons with dementia using the EQ-5D-5L. Results A total of 379 family caregivers participated in the survey. Depressive symptoms were reported in 143 persons with dementia (37.7%). A total of 155 persons with dementia (40.9%) had initiated ACP, of which 88 (56.8%) had care professionals involved in ACP conversation. After adjusting for the characteristics of persons with dementia and caregivers, persons with professional involvement showed significantly more severe depressive symptoms compared to those who did not initiate ACP. There was no significant difference in the quality of life of persons with dementia according to ACP initiation. Conclusions Many home-dwelling persons with dementia experienced depressive symptoms during the COVID-19 pandemic, especially in cases where care professionals were involved in ACP conversations. Optimal and proactive ACP approaches need to be developed to prevent depressive symptoms in newly diagnosed persons.

  42. Auditory Hallucinations and Self-Injurious Behavior in General Population Adolescents: Modeling Within-Person Effects in the Tokyo Teen Cohort International-journal International-coauthorship Peer-reviewed

    Daniel Stanyon, Jordan De Vylder, Syudo Yamasaki, Satoshi Yamaguchi, Shuntaro Ando, Satoshi Usami, Kaori Endo, Mitsuhiro Miyashita, Sho Kanata, Yuko Morimoto, Mariko Hosozawa, Kaori Baba, Naomi Nakajima, Junko Niimura, Miharu Nakanishi, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Schizophrenia Bulletin　49　(2)　329-338　2023/03/15

    Publisher: Oxford University Press (OUP)

    DOI： 10.1093/schbul/sbac155 　

    ISSN： 0586-7614

    eISSN： 1745-1701

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    Abstract Background and Hypotheses A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. Study Design Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. Study Results At the within-person level, AHs were associated with subsequent SIB over the observation period (12y–14y: β = .118, P < .001; 14–16y: β = .086, P = .012). The reverse SIB->AHs relationship was non-significant at 12–14y (β = .047, P = .112) but emerged from 14y to 16y as the primary direction of influence (β = .243, P < .001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. Conclusions A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress.

  43. N-Acetylcysteine Suppresses Microglial Inflammation and Induces Mortality Dose-Dependently via Tumor Necrosis Factor-α Signaling International-journal International-coauthorship Peer-reviewed

    Mai Sakai, Zhiqian Yu, Masayuki Taniguchi, Rosanne Picotin, Nanami Oyama, David Stellwagen, Chiaki Ono, Yoshie Kikuchi, Ko Matsui, Miharu Nakanishi, Hatsumi Yoshii, Tomoyuki Furuyashiki, Takaaki Abe, Hiroaki Tomita

    International Journal of Molecular Sciences　24　(4)　3798-3798　2023/02/14

    Publisher: MDPI AG

    DOI： 10.3390/ijms24043798 　

    eISSN： 1422-0067

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    N-acetylcysteine (NAC) is an antioxidant that prevents tumor necrosis factor (TNF)-α-induced cell death, but it also acts as a pro-oxidant, promoting reactive oxygen species independent apoptosis. Although there is plausible preclinical evidence for the use of NAC in the treatment of psychiatric disorders, deleterious side effects are still of concern. Microglia, key innate immune cells in the brain, play an important role in inflammation in psychiatric disorders. This study aimed to investigate the beneficial and deleterious effects of NAC on microglia and stress-induced behavior abnormalities in mice, and its association with microglial TNF-α and nitric oxide (NO) production. The microglial cell line MG6 was stimulated by Escherichia coli lipopolysaccharide (LPS) using NAC at varying concentrations for 24 h. NAC inhibited LPS-induced TNF-α and NO synthesis, whereas high concentrations (≥30 mM) caused MG6 mortality. Intraperitoneal injections of NAC did not ameliorate stress-induced behavioral abnormalities in mice, but high-doses induced microglial mortality. Furthermore, NAC-induced mortality was alleviated in microglial TNF-α-deficient mice and human primary M2 microglia. Our findings provide ample evidence for the use of NAC as a modulating agent of inflammation in the brain. The risk of side effects from NAC on TNF-α remains unclear and merits further mechanistic investigations.

  44. An online intervention to promote mental health literacy for psychosis amongst parents of adolescents: A pilot randomized controlled trial International-journal Peer-reviewed

    Miharu Nakanishi, Takahiro Tanaka, Atsushi Nishida, Nozomu Mandai, Nobutaka Kitamura, Hatsumi Yoshii

    Early Intervention in Psychiatry　17　(7)　737-742　2023/01/10

    Publisher: Wiley

    DOI： 10.1111/eip.13390 　

    ISSN： 1751-7885

    eISSN： 1751-7893

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    AIM: This study evaluated an online mental health literacy intervention to improve help-seeking for psychosis amongst parents of adolescents. METHODS: A total of 2496 parents of first-grade junior high school students, recruited from a Japan-based survey company, participated in a randomized controlled trial in July 2016; participants were randomly allocated to the intervention (n = 1248) or control group (n = 1248). They were assessed at baseline and one-week post intervention. The intervention group received a 30-minute online educational programme that included a narrative of the mother of an adolescent with psychosis. RESULTS: There were no between-group differences in changes in the rate of 'no help-seeking' in any hypothetical situations of a child's psychosis and prodromal symptoms. CONCLUSIONS: The intervention might have been suboptimal to improve mental health literacy for psychosis amongst parents of adolescents. A narrative message from a service user may be helpful to encourage parents in help-seeking.

  45. Predictors of chronic loneliness during adolescence: a population-based cohort study International-journal International-coauthorship Peer-reviewed

    Mariko Hosozawa, Noriko Cable, Syudo Yamasaki, Shuntaro Ando, Kaori Endo, Satoshi Usami, Miharu Nakanishi, Junko Niimura, Naomi Nakajima, Kaori Baba, Nao Oikawa, Daniel Stanyon, Kazuhiro Suzuki, Mitsuhiro Miyashita, Hiroyasu Iso, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Child and Adolescent Psychiatry and Mental Health　16　(1)　107-107　2022/12/21

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s13034-022-00545-z 　

    eISSN： 1753-2000

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    Abstract Background Adolescent loneliness is a growing public health issue owing to its adverse health impact. Although adolescent loneliness is common, its trajectories can show distinct patterns over time. However, there is limited knowledge regarding their determinants, particularly for chronic loneliness. We aimed to determine the predictors of loneliness trajectories across early-to-mid adolescence and examine their association with later suicidality. Methods Data were collected from 3165 participants from the population-based Tokyo Teen Cohort. Participants reported their loneliness at 10, 12, 14, and 16 years. Loneliness trajectories were identified using latent class growth analysis. We examined the predictive role of bullying victimization and parental psychological distress at age 10 via a multinomial logistic regression. Sociodemographic and child-related factors (i.e., chronic health conditions and cognitive delay) were included as covariates. The association between the trajectories, self-harm, and suicidal ideation by age 16 was investigated using Poisson regression. Results Four trajectories were identified: “consistently low” (2448, 77.3%), “moderate–decreasing” (185, 5.8%), “moderate–increasing” (508, 16.1%), and “consistently high” (24, 0.8%). Taking “consistently low” as a reference, experiences of bullying victimization predicted all the remaining trajectories [adjusted relative risk ratio 1.64, 95% confidence interval (CI) 1.18–2.28 for “moderate–decreasing,” 1.88, 1.52–2.33 for “moderate–increasing,” and 4.57, 1.97–10.59 for “consistently high”]. Parental psychological distress predicted the “moderate–increasing” (1.84, 1.25–2.71) and “consistently high” (5.07, 1.78–14.42) trajectories. The “consistently high” trajectory showed the greatest risk for self-harm and suicidal ideation (adjusted relative risk ratio 6.01, 95% CI 4.40–8.22; 2.48, 1.82–3.37, respectively); however, the “moderate–increasing” and “moderate–decreasing” trajectories were also at increased risk (moderate–increasing: 2.71, 2.23–3.30 for self-harm, 1.93, 1.69–2.19 for suicidal ideation; moderate–decreasing: 2.49, 1.91–3.26 for self-harm, 1.59, 1.33–1.91 for suicidal ideation). Conclusions Bullying victimization and parental psychological distress at age 10 were independent determinants of increased and chronic loneliness trajectories across early-to-mid adolescence. Compared with “consistently low,” all other loneliness trajectories were associated with an increased risk of adolescent suicidality. Interventions targeting adolescent loneliness should include approaches to mitigate bullying and parental psychological distress. These strategies may help prevent adolescent suicidality.

  46. Maternal parenting stress from birth to 36 months, naternal depressive symptoms, and physical punishment to 10-year-old children: A population-based birth cohort study International-journal Peer-reviewed

    Junko Niimura, Miharu Nakanishi, Syudo Yamasaki, Shuntaro Ando, Sho Kanata, Shinya Fujikara, Yuko Morimoto, Kaori Endo, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Social Psychiatry and Psychiatric Epidemiology　57　(11)　2207-2215　2022/11/01

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1007/s00127-022-02319-6 　

    ISSN： 0933-7954

    eISSN： 1433-9285

  47. Suicide rates during the COVID-19 pandemic in Japan from April 2020 to December 2021 International-journal Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Kaori Endo, Shuntaro Ando, Mai Sakai, Hatsumi Yoshii, Atsushi Nishida

    Psychiatry Research　316　114774-114774　2022/09/16

    Publisher: Elsevier BV

    DOI： 10.1016/j.psychres.2022.114774 　

    ISSN： 0165-1781

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    This study estimated the excess suicidal mortality during the COVID-19 pandemic in Japan. A Poisson regression model was used to assess the association between unemployment rates, expenditure for alcohol, eating out, and suicide, from January 2008 to March 2020. The excess suicidal mortality was assessed by applying the identified model to data from April 2020 to December 2021. The number of estimated excess deaths during COVID-19 was 3397 in men and 2390 in women. COVID-19 may have caused unprecedented psychological distress among people, owing to restricted social gatherings and prolonged uncertainties.

  48. Neighborhood social cohesion and dementia-related stigma among mothers of adolescents in the pre- and current COVID-19 period: An observational study using population-based cohort data International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Shuntaro Ando, Kaori Endo, Marcus Richards, Mario Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Journal of Alzheimer's Disease　88　(2)　493-502　2022/07/19

    DOI： 10.3233/JAD-220043 　

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    BACKGROUND: Middle-aged adults may be the ideal target group for dementia-related stigma reduction interventions to encourage the utilization of services among those who may become family caregivers. Neighborhood social cohesion may diminish dementia-related stigma, particularly in terms of perceived public attitudes. The COVID-19 pandemic can further negatively impact perceived public stigma. OBJECTIVE: To investigate the association between neighborhood social cohesion and dementia-related stigma during the pre- and current COVID-19 period. METHODS: We employed a cross-sectional design using data from a large population-based cohort, the Tokyo Teen Cohort, in Japan. Overall, 2,469 mothers of 16-year-old adolescents self-completed a questionnaire comprising nine dementia-related stigma questions evaluating perceived public and personal attitudes. Neighborhood social cohesion was assessed using a five-item instrument. The participants were divided into two groups according to the time of assessment: prior to the pandemic's onset (February 2019-March 2020) and during the pandemic (April 2020-July 2021). A multiple regression analysis of stigma was performed using neighborhood social cohesion as an independent variable, and caring experience, age, educational level, and working status as covariates. RESULTS: Personal and perceived public stigma were significantly lower in participants who perceived greater neighborhood social cohesion. However, level of personal and perceived public stigma did not differ between pre- and during the pandemic period. CONCLUSION: Neighborhood social cohesion may be a modifiable factor for dementia-related stigma. A localized intervention to enhance social cohesion in the neighborhood community would promote the utilization of services among those who may become family caregivers.

  49. The association between COVID-19 information sources and stigma against health care workers among college students: cross-sectional, observational study International-journal Peer-reviewed

    Miharu Nakanishi, Mai Sakai, Gen Takagi, Keita Toshi, Koubun Wakashima, Hatsumi Yoshii

    JMIR Formative Research　6　(7)　e35806-e35806　2022/07/07

    Publisher: JMIR Publications Inc.

    DOI： 10.2196/35806 　

    eISSN： 2561-326X

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    Background The COVID-19 pandemic has triggered stigmatic attitudes against health care workers. Some forms of social media may play a role in disseminating stigmatizing messages. Objective We aimed to investigate the association between COVID-19 information sources and stigma against health care workers among college students during the pandemic. Methods A cross-sectional, observational study was conducted using a web-based platform in the Tohoku region of Japan. College students aged ≥20 years were asked to complete the questionnaire between August 18 and October 31, 2020. Stigma against health care workers was evaluated using a modified Japanese version of the Social Distance Scale. Participants were also asked to rate their perceived vulnerability to infection using the Japanese version of the Perceived Vulnerability to Disease scale. Results A total of 281 students from 8 colleges completed the web-based survey. There were 139 (49.5%) participants who used Twitter, 187 (66.5%) who used news websites, and 46 (16.4%) who used the websites of public health agencies as COVID-19 information sources. After adjusting for age, sex, department, and Perceived Vulnerability to Disease scores, the level of stigma did not differ between students who used Twitter and those who did not. Students who used the websites of public health agencies showed a significantly less stigmatic attitude than those who did not. Conclusions Fact-checking and directing visitors to credible information sources from public health agencies may have prevented the formation of stigmatic attitudes toward health care workers. An effective strategy to enable easy access to information provided by public agencies should be integrated into widespread web-based platforms.

  50. Depression and anxiety among nursing students during the COVID‐19 pandemic in Tohoku region, Japan: A cross‐sectional survey International-journal Peer-reviewed

    Mai Sakai, Miharu Nakanishi, Zhiqian Yu, Gen Takagi, Keita Toshi, Koubun Wakashima, Hatsumi Yoshii

    Japan Journal of Nursing Science　19　(3)　e12483　2022/07/04

    Publisher: Wiley

    DOI： 10.1111/jjns.12483 　

    ISSN： 1742-7932

    eISSN： 1742-7924

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    AIM: Restrictions such as physical distancing and online learning for college students were implemented due to the COVID-19 pandemic. Owing to this, students may experience psychological distress from social isolation and loneliness. Nursing students are subjected to an exacerbated level of distress during the pandemic due to their role as health professionals. Therefore, the present study aimed to investigate the level of anxiety and depression among Japanese nursing students, according to their perceived vulnerability to COVID-19. METHODS: A total of 281 college students (104 nursing students and 177 other college students) responded to a web-based anonymous questionnaire survey from 18 August to 31 October 2020. The Hospital Anxiety and Depression Scale was used to evaluate anxiety (HADS-A) and depression (HADS-D). Perceived vulnerability to COVID-19 was assessed using the Perceived Vulnerability to Disease Scale. RESULTS: In both groups of students, the prevalence of both anxiety (30.5% in nursing students; 69.5% in others) and depressive symptoms (31.1% in nursing students; 68.9% in others) were remarkably high. There were no significant differences in anxiety and depression between nursing and other students after adjusting for perceived vulnerability to COVID-19 plus socio-demographic characteristics and stress coping styles. Perceived vulnerability and its interactions with nursing did not show a significant association with either depression or anxiety. CONCLUSION: This study highlights the need for greater support and preventive strategies for mental health problems for college students during the COVID-19 pandemic regardless of perceived vulnerability.

  51. Family caregivers’ concerns about advance care planning for home-dwelling people with dementia: a cross-sectional observational study in Japan Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Yuki Miyamoto, Syudo Yamasaki, Atsushi Nishida

    BMC Palliative Care　21　(1)　114-114　2022/06/27

    Publisher: Springer Science and Business Media {LLC}

    DOI： 10.1186/s12904-022-01008-0 　

    ISSN： 1472-684X

    eISSN： 1472-684X

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    Abstract Background The importance of advance care planning for people with dementia has increased during the Coronavirus Disease 2019 Pandemic. However, family caregivers may have concerns about having conversations regarding advance care planning with their loved ones, which may hinder the initiation of such planning. This study investigated family caregivers’ concerns regarding conducting advance care planning for home-dwelling individuals with dementia. Methods A prospective cross-sectional study compared the level of family-caregiver concern between those who had initiated advance care planning and those who did not. In June 2021, an internet-based questionnaire survey was administered to Japan-based family caregivers of persons with dementia. Registered members of a Japan-based survey company were recruited; inclusion criteria were being aged 40 years or older and having been a primary, non-professional caregiver of a family member with dementia. Respondents rated their level of agreement with six statements regarding advance-care-planning-related concerns. Respondents also reported their psychological well-being using the WHO-5 Well-Being Index. Results Overall, 379 family caregivers participated in this survey. Of these, 155 (40.9%) reported that their loved ones had initiated advance care planning, of whom 88 (56.8%) stated that care professionals were involved in the advance-care-planning conversations. The level of family-caregiver concern was significantly lower when the loved one initiated the conversation concerning advance care planning. After adjusting for the characteristics of persons with dementia and their caregivers, family caregivers with lower psychological well-being showed significantly higher levels of concern. Conclusions Family caregivers reported concerns regarding conducting advance care planning. There is a need for educational and clinical strategies that encourage professionals to address the psychological needs of family caregivers.

  52. Cross-cultural conceptualization of a good end of life with dementia: a qualitative study International-journal International-coauthorship

    Mayumi Nishimura, Karen Harrison Dening, Elizabeth L. Sampson, Edison Iglesias de Oliveira Vidal, Wilson Correia de Abreu, Sharon Kaasalainen, Yvonne Eisenmann, Laura Dempsey, Kirsten J. Moore, Nathan Davies, Sascha R. Bolt, Judith M. M. Meijers, Natashe Lemos Dekker, Mitsunori Miyashita, Miharu Nakanishi, Takeo Nakayama, Jenny T. van der Steen

    BMC Palliative Care　21　(1)　2022/06/08

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s12904-022-00982-9 　

    eISSN： 1472-684X

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    Abstract Background Research on the nature of a “good death” has mostly focused on dying with cancer and other life-limiting diseases, but less so on dementia. Conceptualizing common cross-cultural themes regarding a good end of life in dementia will enable developing international care models. Methods We combined published qualitative studies about end of life with dementia, focus group and individual interviews with the researchers, and video-conferencing and continuous email discussions. The interviews were audio-recorded and transcribed verbatim. The data were analyzed thematically, and the researchers developed common themes referring to their original studies. Results Fourteen qualitative researchers representing 14 cross-cultural studies covering qualitative data of 121 people with dementia and 292 family caregivers. The researchers and data were from eight countries UK, The Netherlands, Japan, Portugal, Germany, Canada, Brazil, and Ireland. Three focus groups, five individual interviews, and video-conferencing were conducted and feedback on multiple iterations was gained by 190 emails between May 2019 and April 2020 until consensus was achieved. Nine cross-culturally common themes emerged from the discussions and shared interpretation of the data of persons with dementia and family caregivers. Three represent basic needs: “Pain and Symptoms Controlled,” “Being Provided Basic Care,” and “A Place like Home.” Other themes were “Having Preferences Met,” “Receiving Respect as a Person,” “Care for Caregivers,” “Identity Being Preserved,” “Being Connected,” and “Satisfaction with Life and Spiritual Well-being.” “Care for Caregivers” showed the greatest difference in emphasis across cultures. Good relationships were essential in all themes. Conclusions The common cross-cultural themes comprise a framework underpinned by value placed on personhood and dignity, emphasizing that interdependency through relationships is essential to promote a good end of life with dementia. These themes and valuing the importance of relationships as central to connecting the themes could support care planning and further development of a dementia palliative care model. Trial registration The Graduate School and Faculty of Medicine Kyoto University (R1924–1).

  53. Self-reported maternal parenting stress from 9m predicts child ADHD at age 12: findings from a population-based birth cohort study International-journal Peer-reviewed

    Kaori Endo, Daniel Stanyon, Syudo Yamasaki, Miharu Nakanishi, Junko Niimura, Sho Kanata, Shinya Fujikawa, Yuko Morimoto, Mariko Hosozawa, Kaori Baba, Nao Oikawa, Naomi Nakajima, Kazuhiro Suzuki, Mitsuhiro Miyashita, Shuntaro Ando, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Frontiers in Psychiatry　13　806669　2022/04/28

    Publisher: Frontiers Media SA

    DOI： 10.3389/fpsyt.2022.806669 　

    eISSN： 1664-0640

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    Background Attention-deficit/hyperactivity disorder (ADHD) develops in early childhood and carries lifelong impact, but early identification and intervention ensure optimal clinical outcomes. Prolonged or excessive parenting stress may be a response to infant behavioral differences antecedent to developmental disorders such as ADHD, and therefore represents a potentially valuable inclusion in routine early-life assessment. To investigate the feasibility of using routinely-collected self-reported maternal parenting stress as a risk marker for child ADHD, this study investigated the longitudinal association between maternal parenting stress from 1 to 36 months after childbirth and child ADHD in early adolescence. Methods The sample comprised 2,638 children (1,253 girls) from the Tokyo Teen Cohort population-based birth cohort study. Mothers recorded parenting stress five times from 1 to 36 months following childbirth in the Maternal and Child Health Handbook, a tool used for routine early-life assessment in Japan. Nine years later, mothers evaluated their child's ADHD symptoms at 12 y using the hyperactivity/inattention subscale from the Strength and Difficulties Questionnaire. Results Approximately 7.5% of parents reported that they had parenting stress at 36 m after childbirth. 6.2% of children were evaluated as above the cut-off for ADHD symptoms at 12 y. Parenting stress at 1 and 3–4 m was not associated with child ADHD symptoms at 12 y. However, child ADHD symptoms at 12 y was significantly associated with parenting stress at 9–10 m (unadjusted OR = 1.42, p =.047, 95% CI [1.00, 2/00]), 18 m (unadjusted OR = 1.57, p =.007, 95% CI [1.13, 2.19]) and 36 m (unadjusted OR = 1.67, p =.002, 95% CI [1.20, 2.31]). These associations remained after adjustment for child's sex, age in months and family income. Conclusions We identified associations between parenting stress at 9–10, 18 and 36 m after childbirth and child ADHD symptoms at 12 years old. Self-reported parenting stress data may have utility as an early indicator for ADHD risk. Participation in early-life health checks, assessment of parenting stress, and tailoring support to family needs should be promoted for early identification and intervention for ADHD.

  54. Role of advanced glycation end products in the longitudinal association between muscular strength and psychotic symptoms among adolescents International-journal International-coauthorship Peer-reviewed

    Kazuhiro Suzuki, Syudo Yamasaki, Mitsuhiro Miyashita, Shuntaro Ando, Kazuya Toriumi, Akane Yoshikawa, Miharu Nakanishi, Yuko Morimoto, Sho Kanata, Shinya Fujikawa, Kaori Endo, Shinsuke Koike, Satoshi Usami, Masanari Itokawa, Shinsuke Washizuka, Mariko Hiraiwa-Hasegawa, Herbert Y. Meltzer, Kiyoto Kasai, Atsushi Nishida, Makoto Arai

    Schizophrenia　8　(1)　44　2022/04/27

    DOI： 10.1038/s41537-022-00249-5 　

    eISSN： 2334-265X

  55. Association between maternal perceived capacity in life and physical punishment of teenage children: a longitudinal analysis of a population-based cohort in Tokyo, Japan International-journal Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Junko Niimura, Kaori Endo, Naomi Nakajima, Daniel Stanyon, Kaori Baba, Nao Oikawa, Mariko Hosozawa, Shuntaro Ando, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    BMJ Open　12　(3)　e058862-e058862　2022/03/17

    Publisher: BMJ

    DOI： 10.1136/bmjopen-2021-058862 　

    ISSN： 2044-6055

    eISSN： 2044-6055

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    Objectives Perceived capacity denotes a subjective sense of having resources to cope with strains and hardships, and hence maternal perceived capacity may be protective against risk factors for child maltreatment. This study investigated the longitudinal association between maternal perceived capacity in life and child maltreatment. Design This population-based longitudinal study used self-reported questionnaires from the Tokyo Teen Cohort study (TTC), a large community-based cohort study conducted in Japan between 2014 and 2019. Setting Mother–child pairs were randomly recruited from the resident registries of three municipalities in Tokyo, Japan. Methods A total of 2515 mothers participated. Mothers’ perceived capacity in life was evaluated using the self-reported TTC wave 2 survey when their children were 12 years old. Mothers rated the extent to which they had capacity in terms of time, finance, physical well-being, mental well-being and life in general. Physical punishment, which is linked to more severe childhood maltreatment, was assessed using a question about the use of physical punishment at the wave 3 survey when children were 14 years old. Results After controlling for baseline covariates (including maternal social support, age, marital status, annual household income, educational attainment, child’s age, gender, sibling and birth order, and behavioural difficulties), higher perceived capacity in finance (OR 0.95, 95% CI 0.90 to 0.99, p=0.026) and mental well-being (OR 0.93, 95% CI 0.88 to 0.98, p=0.005) were associated with less frequent use of physical punishment with 14-year-old children. Conclusions Maternal perceived capacity in finance and mental well-being may decrease the risk of frequent use of physical punishment at the 2-year follow-up. Child maltreatment prevention strategies should aim to empower mothers and promote their perceived capacity in financial management and mental health.

  56. The Revised Medical Care Act is associated with a decrease in hospital death for the total Japanese older adult population regardless of dementia status: An interrupted time series analysis International-coauthorship Peer-reviewed

    Joost D. Wammes, Miharu Nakanishi, Jenny T. van der Steen, Janet L. MacNeil Vroomen

    PLOS ONE　17　(3)　e0264624　2022/03/03

    Publisher: Public Library of Science ({PLoS})

    DOI： 10.1371/journal.pone.0264624 　

    ISSN： 1932-6203

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    <jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>In 2006, Japan introduced the Revised Medical Care Act aimed to shift end-of-life care from hospitals to communities. For patients and families, dying in hospital can be highly distressing. Persons with dementia are especially susceptible to negative hospital-related outcomes. This study aims to evaluate whether the Revised Medical Care Act is associated with a decrease in the proportion of hospital deaths for older adults and persons with dementia over a 20-year period covering the reform.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Methods and findings</jats:title> <jats:p>This is a population-level, repeated cross-sectional study using mortality data from Vital Statistics Japan. Participants were Japanese older adults 65 years or older with and without dementia who died between 1996 and 2016. The policy intervention was the 2006 Revised Medical Care Act that increased community care infrastructure. The primary outcome was location of death in hospital, nursing home, home, or elsewhere. The trend in the proportion of location of death, before and after the reforms was estimated using an interrupted time-series analysis. All analyses were adjusted for sex and seasonality. Of the 19,307,104 older adult decedents, 216,442 had dementia identified on their death certificate. Death in nursing home (1.10, 95% CI 1.10–1.10), home (1.08, 95% CI 1.08–1.08), and elsewhere (1.07, 95% CI 1.07–1.07) increased over time compared to hospital deaths for the total population after reform implementation. Nursing home (1.04, 95% CI 1.03–1.05) and home death (1.11, 95% CI 1.10–1.12) increased after reform implementation for persons with dementia.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Conclusion</jats:title> <jats:p>This study provides evidence that the 2006 Revised Medical Care Act was associated with decreased older adults dying in hospital regardless of dementia status; however, hospital continues as the primary location of death.</jats:p> </jats:sec>

  57. Deficient Autophagy in Microglia Aggravates Repeated Social Defeat Stress-Induced Social Avoidance. International-journal International-coauthorship

    Mai Sakai, Zhiqian Yu, Ryo Hirayama, Masa Nakasato, Yoshie Kikuchi, Chiaki Ono, Hiroshi Komatsu, Miharu Nakanishi, Hatsumi Yoshii, David Stellwagen, Tomoyuki Furuyashiki, Masaaki Komatsu, Hiroaki Tomita

    Neural plasticity　2022　7503553-7503553　2022/02/16

    DOI： 10.1155/2022/7503553 　

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    Major depressive disorder (MDD) is associated with repeated exposure to environmental stress. Autophagy is activated under various stress conditions that are associated with several diseases in the brain. This study was aimed at elucidating the autophagy signaling changes in the prefrontal cortex (PFC) under repeated social defeat (RSD) to investigate the involvement of microglial autophagy in RSD-induced behavioral changes. We found that RSD stress, an animal model of MDD, significantly induced initial autophagic signals followed by increased transcription of autophagy-related genes (Atg6, Atg7, and Atg12) in the PFC. Similarly, significantly increased transcripts of ATGs (Atg6, Atg7, Atg12, and Atg5) were confirmed in the postmortem PFC of patients with MDD. The protein levels of the prefrontal cortical LC3B were significantly increased, whereas p62 was significantly decreased in the resilient but not in susceptible mice and patients with MDD. This indicates that enhanced autophagic flux may alleviate stress-induced depression. Furthermore, we identified that FKBP5, an early-stage autophagy regulator, was significantly increased in the PFC of resilient mice at the transcript and protein levels. In addition, the resilient mice exhibited enhanced autophagic flux in the prefrontal cortical microglia, and the autophagic deficiency in microglia aggravated RSD-induced social avoidance, indicating that microglial autophagy involves stress-induced behavioral changes.

  58. Psychotic experiences predict subsequent loneliness among adolescents: A population-based birth cohort study International-journal International-coauthorship Peer-reviewed

    Kaori Endo, Syudo Yamasaki, Miharu Nakanishi, Jordan DeVylder, Satoshi Usami, Yuko Morimoto, Daniel Stanyon, Kazuhiro Suzuki, Mitsuhiro Miyashita, Makoto Arai, Shinya Fujikawa, Sho Kanata, Shuntaro Ando, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Schizophrenia Research　239　123-127　2022/01/01

    Publisher: Elsevier BV

    DOI： 10.1016/j.schres.2021.11.031 　

    ISSN： 0920-9964

  59. The role of bullying victimization in the pathway between autistic traits and psychotic experiences in adolescence: Data from the Tokyo Teen Cohort study International-journal International-coauthorship Peer-reviewed

    Daniel Stanyon, Syudo Yamasaki, Shuntaro Ando, Kaori Endo, Miharu Nakanishi, Tomoki Kiyono, Mariko Hosozawa, Sho Kanata, Shinya Fujikawa, Yuko Morimoto, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Schizophrenia Research　239　111-115　2022/01/01

    Publisher: Elsevier BV

    DOI： 10.1016/j.schres.2021.11.015 　

    ISSN： 0920-9964

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    Autistic traits are associated with psychotic experiences in adolescence; however, the mechanisms underlying this relationship are not well understood. Prior research indicates that bullying victimization increases the risk of psychotic experiences in general adolescent populations, and autistic youth are at higher risk of being bullied than their non-autistic peers. Using longitudinal data from general population adolescents aged 10-14 in the Tokyo Teen Cohort study, we tested the hypothesis that bullying is responsible for the association between autistic traits and psychotic experiences in adolescence. We identified an indirect effect (estimate = 0.033 [95% CIs: 0.014-0.057], p < 0.001) between autistic traits and psychotic experiences via bullying victimization, even after controlling for known confounders. Prevention of bullying victimization may be one avenue for reducing risk of psychosis among adolescents with high levels of autistic traits.

  60. e-Learning and Web-Based Tools for Psychosocial Interventions Addressing Neuropsychiatric Symptoms of Dementia During the COVID-19 Pandemic in Tokyo, Japan: Quasi-Experimental Study International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Kaori Endo, Junko Niimura, Canan Ziylan, Ton Bakker, Eva Granvik, Katarina Nägga, Atsushi Nishida

    JMIR Medical Education　7　(4)　e30652-e30652　2021/10/12

    Publisher: JMIR Publications Inc.

    DOI： 10.2196/30652 　

    eISSN： 2369-3762

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    Background Concern has been raised that the COVID-19 pandemic and consequent social distancing measures may increase neuropsychiatric symptoms in people with dementia. Thus, we developed and delivered an e-learning training course to professional caregivers on using a web-based tool for psychosocial interventions for people with dementia. Objective The aim of our study was to evaluate the feasibility and efficacy of an e-learning course in combination with a web-based tool in addressing neuropsychiatric symptoms of dementia. Methods A quasi-experimental design was used in Tokyo, Japan. The e-learning course was delivered three times to professional caregivers between July and December 2020. Caregivers who completed the course assessed the level of neuropsychiatric symptoms in people with dementia using the total score from the Neuropsychiatric Inventory (NPI) via a web-based tool. The primary outcome measures were the number of caregivers who implemented follow-up NPI evaluations by March 2021 and the change in NPI scores from baseline to their most recent follow-up evaluations. As a control group, information was also obtained from professional caregivers who completed a face-to-face training course using the same web-based tool between July 2019 and March 2020. Results A total of 268 caregivers completed the e-learning course in 2020. Of the 268 caregivers, 56 (20.9%) underwent follow-up evaluations with 63 persons with dementia. The average NPI score was significantly reduced from baseline (mean 20.4, SD 16.2) to the most recent follow-up evaluations (mean 14.3, SD 13.4). The effect size was assumed to be medium (Cohen drm [repeated measures]=0.40). The control group consisted of 252 caregivers who completed a face-to-face training course. Of the 252 caregivers, 114 (45.2%) underwent follow-up evaluations. Compared to the control group, caregivers who completed the e-learning course were significantly less likely to implement follow-up evaluations (χ21=52.0, P&lt;.001). The change in NPI scores did not differ according to the type of training course (baseline-adjusted difference=–0.61, P=.69). Conclusions The replacement of face-to-face training with e-learning may have provided professionals with an opportunity to participate in the dementia behavior analysis and support enhancement (DEMBASE) program who may not have participated in the program otherwise. Although the program showed equal efficacy in terms of the two training courses, the feasibility was suboptimal with lower implementation levels for those receiving e-learning training. Thus, further strategies should be developed to improve feasibility by providing motivational triggers for implementation and technical support for care professionals. Using online communities in the program should also be investigated.

  61. Factors of feelings of happiness at work among staff in geriatric care facilities International-journal Peer-reviewed

    Maki Tei‐tominaga, Miharu Nakanishi

    Geriatrics & Gerontology International　21　(9)　818-824　2021/09/01

    Publisher: Wiley

    DOI： 10.1111/ggi.14247 　

    ISSN： 1444-1586

    eISSN： 1447-0594

  62. Costs and resource use of community-dwelling patients with Alzheimer’s disease in Japan: 18-month results from the GERAS-J study International-coauthorship Peer-reviewed

    Miharu Nakanishi, Ataru Igarashi, Kaname Ueda, Alan J. M. Brnabic, Taka Matsumura, Kenichi Meguro, Masahito Yamada, Masaru Mimura, Heii Arai, Tamas Treuer

    Current Medical Research and Opinion　37　(8)　1331-1339　2021/08/03

    Publisher: Informa {UK} Limited

    DOI： 10.1080/03007995.2021.1922369 　

    ISSN： 0300-7995

    eISSN： 1473-4877

  63. Factors of professional caregivers' intention to work: A qualitative study Peer-reviewed

    Maki Tominaga, Miharu Nakanishi

    Nihon Koshu Eisei Zasshi (Janaese Journal of Public Health)　68　(7)　468-476　2021/07/15

    DOI： 10.11236/jph.20-084 　

  64. Facilitators and barriers associated with the implementation of a Swedish psychosocial dementia care programme in Japan: A secondary analysis of qualitative and quantitative data. International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Canan Ziylan, Ton Bakker, Eva Granvik, Katarina Nägga, Atsushi Nishida

    Scandinavian Journal of Caring Sciences　35　(2)　430-441　2021/06/01

    Publisher: Wiley

    DOI： 10.1111/scs.12854 　

    ISSN： 0283-9318

    eISSN： 1471-6712

  65. On-site Dining in Tokyo During the COVID-19 Pandemic: Time Series Analysis Using Mobile Phone Location Data International-journal Peer-reviewed

    Miharu Nakanishi, Ryosuke Shibasaki, Syudo Yamasaki, Satoshi Miyazawa, Satoshi Usami, Hiroshi Nishiura, Atsushi Nishida

    JMIR mHealth and uHealth　9　(5)　e27342-e27342　2021/05/11

    Publisher: JMIR Publications Inc.

    DOI： 10.2196/27342 　

    eISSN： 2291-5222

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    <sec> <title>Background</title> During the second wave of COVID-19 in August 2020, the Tokyo Metropolitan Government implemented public health and social measures to reduce on-site dining. Assessing the associations between human behavior, infection, and social measures is essential to understand achievable reductions in cases and identify the factors driving changes in social dynamics. </sec> <sec> <title>Objective</title> The aim of this study was to investigate the association between nighttime population volumes, the COVID-19 epidemic, and the implementation of public health and social measures in Tokyo. </sec> <sec> <title>Methods</title> We used mobile phone location data to estimate populations between 10 PM and midnight in seven Tokyo metropolitan areas. Mobile phone trajectories were used to distinguish and extract on-site dining from stay-at-work and stay-at-home behaviors. Numbers of new cases and symptom onsets were obtained. Weekly mobility and infection data from March 1 to November 14, 2020, were analyzed using a vector autoregression model. </sec> <sec> <title>Results</title> An increase in the number of symptom onsets was observed 1 week after the nighttime population volume increased (coefficient=0.60, 95% CI 0.28 to 0.92). The effective reproduction number significantly increased 3 weeks after the nighttime population volume increased (coefficient=1.30, 95% CI 0.72 to 1.89). The nighttime population volume increased significantly following reports of decreasing numbers of confirmed cases (coefficient=–0.44, 95% CI –0.73 to –0.15). Implementation of social measures to restaurants and bars was not significantly associated with nighttime population volume (coefficient=0.004, 95% CI –0.07 to 0.08). </sec> <sec> <title>Conclusions</title> The nighttime population started to increase after decreasing incidence of COVID-19 was announced. Considering time lags between infection and behavior changes, social measures should be planned in advance of the surge of an epidemic, sufficiently informed by mobility data. </sec>

  66. Defining a good death for people with dementia: a scoping review. International-journal Peer-reviewed

    Zaiya Takahashi, Miyae Yamakawa, Miharu Nakanishi, Hiroki Fukahori, Ayumi Igarashi, Maho Aoyama, kazuki Sato, Shima Sakai, Hiroko Nagae, Mitsunori Miyashita

    Japan Journal of Nursing Science　18　(2)　e12402　2021/04/01

    Publisher: Wiley

    DOI： 10.1111/jjns.12402 　

    ISSN： 1742-7932

    eISSN： 1742-7924

  67. Adolescent problem gaming and loot box purchasing in video games: A cross-sectional observational study using population-based cohort data. International-journal Peer-reviewed

    Soichiro Ide, Miharu Nakanishi, Syudo Yamasaki, Kazutaka Ikeda, Shuntaro Ando, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    JMIR Serious Games　9　(1)　e23886-e23886　2021/02/09

    Publisher: JMIR Publications Inc.

    DOI： 10.2196/23886 　

    eISSN： 2291-9279

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    <sec> <title>Background</title> Video game loot boxes, which can typically be purchased by players or are given as reward, contain random virtual items, or loot, ranging from simple customization options for a player's avatar or character, to game-changing equipment such as weapons and armor. Loot boxes have drawn concern, as purchasing loot boxes might lead to the development of problematic gambling for adolescents. Although parental problem gambling is associated with adolescent problem gambling, no studies have evaluated the prevalence of loot box purchases in adolescents’ parents. </sec> <sec> <title>Objective</title> This study investigated the association between loot box purchasing among adolescents and parents, and problem online gaming in population-based samples. </sec> <sec> <title>Methods</title> In total, 1615 adolescent (aged 14 years) gamers from Japan responded to a questionnaire regarding their loot box purchasing and problem online gaming behaviors. Problem online gaming was defined as four or more of the nine addictive behaviors from the Diagnostic and Statistical Manual of Mental Disorders. The adolescents’ primary caregivers were asked about their loot box purchasing. </sec> <sec> <title>Results</title> Of the 1615 participants, 57 (3.5%) reported loot box purchasing. This prevalence did not differ according to primary caregivers’ loot box purchasing, but adolescents who purchased loot boxes were significantly more likely to exhibit problem online gaming (odds ratio 3.75, 95% CI 2.17-6.48). </sec> <sec> <title>Conclusions</title> Adolescent loot box purchasing is linked to problem online gaming, but not with parents’ loot box purchasing. Measures to reduce these behaviors should target reducing addictive symptoms in young video gamers. </sec>

  68. Inclusion of palliative care in health care policy for older people: A directed documentary analysis in 13 of the most rapidly ageing countries worldwide International-journal International-coauthorship Peer-reviewed

    Lara Pivodic, Tinne Smets, Merryn Gott, Katherine E Sleeman, Borja Arrue, Marylou Cardenas Turanzas, Karolina Pechova, Hana Kodba Čeh, Tong Jen Lo, Miharu Nakanishi, YongJoo Rhee, Maud ten Koppel, Donna M Wilson, Lieve Van den Block

    Palliative Medicine　35　(2)　369-388　2021/02/01

    Publisher: SAGE Publications

    DOI： 10.1177/0269216320972036 　

    ISSN： 0269-2163

    eISSN： 1477-030X

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    <sec><title>Background:</title> Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. </sec><sec><title>Aim:</title> (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. </sec><sec><title>Design:</title> Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. </sec><sec><title>Setting:</title> Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. </sec><sec><title>Results:</title> Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). </sec><sec><title>Conclusions:</title> Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy. </sec>

  69. System-level barriers to personal recovery in mental health: qualitative analysis of co-productive narrative dialogues between users and professionals International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, George Kurokawa, Junko Niimura, Atsushi Nishida, Geoff Shepherd, Syudo Yamasaki

    BJPsych Open　7　(1)　e25　2021/01/07

    Publisher: Royal College of Psychiatrists

    DOI： 10.1192/bjo.2020.156 　

    eISSN： 2056-4724

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    <sec id="S2056472420001568_sec_a1"> <title>Background</title> No co-productive narrative synthesis of system-level facilitators and barriers to personal recovery in mental illness has been undertaken. </sec> <sec id="S2056472420001568_sec_a2"> <title>Aims</title> To clarify system-level facilitators and barriers to personal recovery of people with mental illness. </sec> <sec id="S2056472420001568_sec_a3" sec-type="methods"> <title>Method</title> Qualitative study guided by thematic analysis. Data were collected through one focus group, which involved seven service users and three professionals. This group had 11 meetings, each lasting 2 h at a local research institute, between July 2016 to January 2018. </sec> <sec id="S2056472420001568_sec_a4" sec-type="results"> <title>Results</title> The analysis yielded three themes: barriers inhibiting positive interaction within personal relationship networks, roots of barriers from mental health systems and the social cultural context, and possible solutions to address the roots. Barriers were acknowledged as those related to sense of safety, locus of control within oneself and reunion with self. The roots of barriers were recognised within mental health services, including system without trauma sensitivity, lack of advocacy support and limited access to psychosocial approaches. Roots from social cultural context were also found. There were no narratives relating to facilitators. A possible solution was to address the roots from systems. Social cultural change was called for that makes personalised goals most valued, with an inclusive design that overcomes stigma, to achieve an open and accepting community. </sec> <sec id="S2056472420001568_sec_a5" sec-type="conclusions"> <title>Conclusions</title> The analysis yielded system-level barriers specific to each recovery process. Roots of barriers that need transformation to facilitate personal recovery were identified within mental health services. Social interventions should be further explored to translate the suggested social cultural changes into action. </sec>

  70. Time Investment for Program Implementation to Manage Neuropsychiatric Symptoms: An Observational Longitudinal Study in In-Home and Residential Care Settings International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Junko Niimura, Canan Ziylan, Ton TJEM Bakker, Eva Granvik, Katarina Nägga, Yumi Shindo, Atsushi Nishida

    Journal of Alzheimer's Disease Reports　4　(1)　441-453　2020/10/24

    Publisher: IOS Press

    DOI： 10.3233/adr-200235 　

    eISSN： 2542-4823

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    Background: There are no studies on how the same psychosocial dementia care program is adapted to both in-home and residential care settings. Objective: To evaluate the time investment required by professionals to implement a psychosocial dementia care program to manage neuropsychiatric symptoms. Methods: A prospective observational study design was used. The program consisted of 1) a one-day training course, 2) three interdisciplinary discussion meetings in five months, and 3) a web-based tool for the continued assessment of neuropsychiatric symptoms. Care professionals implemented the intervention in in-home (19 in-home care management agencies and 14 multiple in-home service providers) and residential care settings (19 group homes and eight nursing homes) in Japan from October 2019 to February 2020. The level of neuropsychiatric symptoms for the participants was evaluated using the Neuropsychiatric Inventory (NPI: 0–144). The time investment was reported by participating professionals. A total of 125 persons with dementia were included at baseline. Results: Neuropsychiatric symptoms were significantly decreased at the final follow-up in all types of providers (Cohen’s drm = 0.44–0.61). The mean (SD) time required for the five-month implementation was 417.9 (219.8) minutes. There was a mean (SD) decrease of 8.6 (14.0) points in the total NPI score among the 103 persons with completed interventions. The time investment was significantly lower in in-home care management agencies than in group homes, and lower in follow-ups than at baseline assessment. Conclusion: The program implementation may incur a substantial time investment regardless of setting. An additional benefit scheme to reward the time investment would be helpful to encourage implementation until the follow-ups.

  71. Factors related to turnover intentions and work-related injuries and accidents among professional caregivers: a cross-sectional questionnaire study International-journal Peer-reviewed

    Maki Tei-tominaga, Miharu Nakanishi

    Environmental Health and Preventive Medicine　25　(1)　24　2020/06/26

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s12199-020-00863-8 　

    ISSN： 1342-078X

    eISSN： 1347-4715

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    Abstract Background The Japanese health and welfare industry has a shortage of professional caregivers, and work-related accidents and injuries among this group are therefore especially critical issues. This study aimed to examine the factors associated with turnover intentions and work-related injuries and accidents among professional caregivers in Japan. Methods Self-report questionnaires were distributed to care workers (N= 1396) at 26 geriatric-care facilities. The questionnaire addressed basic attributes, work and organizational characteristics, wage adequacy, and intrinsic motivations for work (e.g., “being suited to caring work”). Social-relational aspects of the work environment were assessed via three subscales of the Social Capital and Ethical Climate in the Workplace instrument (i.e., “Social Capital in the Workplace,” “Exclusive Workplace Climate,” and “Ethical Leadership”). Dependent variables were the experience of work-related accidents or injuries in the prior year and organizational and occupational turnover intentions. We used datasets of professional caregivers for analyses. Results The response rate was 68% (N= 949). Among the 667 professional caregivers, 63% were female. On multivariable logistic regression analysis for work-related accidents and injuries for each sex, those with higher scores for “being suited to caring work” were found to experience significantly fewer work-related accidents and injuries (odds ratio [OR] = 0.78,p&lt; 0.01) among female caregivers. Male caregivers who perceived an exclusive workplace climate experienced more work-related accidents and injuries (OR = 1.61,p&lt; 0.01). However, experience of work-related accidents and injuries did not show significant relationships with organizational and occupational turnover intentions. Additionally, “being suited to caring work” (OR = 0.73,p&lt; 0.01) and ethical leadership (OR = 0.76,p&lt; 0.05) were found to be negatively associated with organizational turnover intentions. “Being suited to caring work” (OR = 0.61,p&lt; 0.01), inadequacy of wage (OR = 2.22,p&lt; 0.05), and marital status (OR = 2.69,p&lt; 0.01) were also associated with occupational turnover intentions of professional caregivers. Conclusions These findings highlight the need to foster intrinsic motivations for work as well as providing a supportive and ethical work environment to reduce high turnover rates and work-related injuries and accidents among professional caregivers.

  72. Impact of dementia on quality of death among cancer patients: An observational study of home palliative care users. International-journal Peer-reviewed

    Kayo Hirooka, Miharu Nakanishi, Hiroki Fukahori, Atsushi Nishida

    Geriatrics & Gerontology International　20　(4)　354-359　2020/02/04

    DOI： 10.1111/ggi.13860 　

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    AIM: The number of cancer patients with dementia has increased markedly in accordance with aging societies. Cancer patients might receive palliative and end-of-life care to maintain their quality of life; however, the impact of dementia on the quality of death is unexamined in this population. Consequently, we explored the impact of dementia on the quality of death among cancer patients. METHODS: Home palliative care staff members completed questionnaires regarding cancer patients' (n = 508) cognitive status, cancer-related symptoms and quality of death using the good death inventory. Hierarchical regression analyses were carried out for the entire sample and for stratified groups based on the presence of dementia. RESULTS: Of the 508 patients, 156 (30.7%) had dementia. Hierarchical regression analyses revealed that greater quality of death was associated with not having dementia (P < 0.001). Stratified analyses showed that dying at home was related to greater quality of death both in patients with and without dementia. The presence of a primary family caregiver was associated with greater quality of death only in patients with dementia (P < 0.001). CONCLUSIONS: Cancer patients with dementia were less likely to achieve a good death than those without. Our results suggest the importance of enhancing end-of-life care discussions with patients and their families, along with developing specific support strategies to enhance the decision-making of cancer patients with dementia and their family members. Geriatr Gerontol Int 2020; ••: ••-••.

  73. Dog and Cat Ownership Predicts Adolescents’ Mental Well-Being: A Population-Based Longitudinal Study International-journal Peer-reviewed

    Kaori Endo, Syudo Yamasaki, Shuntaro Ando, Takefumi Kikusui, Kazutaka Mogi, Miho Nagasawa, itsuka kamimura, Junko Ishihara, Miharu Nakanishi, Satoshi Usami, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    International Journal of Environmental Research and Public Health　17　(3)　884　2020/01/31

    DOI： 10.3390/ijerph17030884 　

  74. Availability of home palliative care services and dying at home in conditions needing palliative care: A population-based death certificate study International-journal Peer-reviewed

    Miharu Nakanishi, Asao Ogawa, Atsushi Nishida

    Palliative Medicine　34　(4)　504-512　2020/01/23

    DOI： 10.1177/0269216319896517 　

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    BACKGROUND: Avoiding inappropriate care transition and enabling people with chronic diseases to die at home have become important health policy issues. Availability of palliative home care services may be related to dying at home. AIM: After controlling for the presence of hospital beds and primary care physicians, we examined the association between availability of home palliative care services and dying at home in conditions requiring such services. DESIGN: Death certificate data in Japan in 2016 were linked with regional healthcare statistics. SETTING/PARTICIPANTS: All adults (18 years or older) who died from conditions needing palliative care in 2016 in Japan were included. RESULTS: There were 922,756 persons included for analysis. Malignant neoplasm (37.4%) accounted for most decedents, followed by heart disease including cerebrovascular disease (31.4%), respiratory disease (14.7%) and dementia/Alzheimer's disease/senility (11.5%). Of decedents, 20.8% died at home or in a nursing home and 79.2% died outside home (hospital/geriatric intermediate care facility). Death at home was more likely in health regions with fewer hospital beds and more primary care physicians, in total and per condition needing palliative care. Number of home palliative care services was negatively associated with death at home. The adjustment for home palliative care services disappeared in heart disease including cerebrovascular disease and reversed in respiratory disease. CONCLUSION: Specialised home palliative care services may be suboptimal, and primary care services may serve as a key access point in providing baseline palliative care to people with conditions needing palliative care. Therefore, primary care services should aim to enhance their palliative care workforce.

  75. Costs and resource use associated with community-dwelling patients with Alzheimer’s disease in Japan: Baseline results from the prospective observational GERAS-J study International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Ataru Igarashi, Kaname Ueda, Alan J.M. Brnabic, Tamas Treuer, Masayo Sato, Kristin Kahle-Wrobleski, Kenichi Meguro, Masahito Yamada, Masaru Mimura, Heii Arai

    Journal of Alzheimer's Disease　74　(1)　127-138　2020/01/19

    DOI： 10.3233/JAD-190811 　

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    BACKGROUND: As the Japanese population ages, caring for people with Alzheimer's disease (AD) dementia is becoming a major socioeconomic issue. OBJECTIVE: To determine the contribution of patient and caregiver costs to total societal costs associated with AD dementia. METHODS: Baseline data was used from the longitudinal, observational GERAS-J study. Using the Mini-Mental State Examination (MMSE) score, patients routinely visiting memory clinics were stratified into three groups based on AD severity. Health care resource utilizationwas recorded using the Resource Utilization in Dementia questionnaire. Total monthly societal costs were estimated using Japan-specific unit costs of services and products (patient direct health care use, patient social care use, and informal caregiving time). Uncertainty around mean costs was estimated using bootstrapping methods. RESULTS: Overall, 553 community-dwelling patients withADdementia (28.3% mild[MMSE21-26], 37.8% moderate[MMSE 15-20], and 34.0% moderately severe/severe [MMSE < 14]) and their caregivers were enrolled. Patient characteristics were: mean age 80.3 years, 72.7% female, and 13.6% living alone. Caregiver characteristics were: mean age 62.1 years, 70.7% female, 78.8% living with patient, 49.0% child of patient, and 39.2% sole caregiver. Total monthly societal costs of AD dementia (Japanese yen) were: 158,454 (mild), 211,301 (moderate), and 294,224 (moderately severe/severe). Informal caregiving costs comprised over 50% of total costs. CONCLUSION: Baseline results of GERAS-J showed that total monthly societal costs associated with AD dementia increased with AD severity. Caregiver-related costs were the largest cost component. Interventions are needed to decrease informal costs and decrease caregiver burden.

  76. The impact of Suicide Prevention Act (2006) on suicides in Japan: An interrupted time-series analysis International-journal Peer-reviewed

    Miharu Nakanishi, Kaori Endo, Shuntaro Ando, Atsushi Nishida

    Crisis　41　(1)　24-31　2020/01/01

    DOI： 10.1027/0227-5910/a000599 　

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    Background: The Suicide Prevention Act was implemented in 2006 in Japan to promote various suicide prevention strategies. Aims: The present study examined the impact of the Suicide Prevention Act on recent suicide mortality rates in Japan. Method: Using an interrupted time-series design, we analyzed monthly mortality rates between January 1996 and December 2016. Death certificate data from vital statistics were obtained. Results: A total of 597,007 suicides (99.3% of all suicides) were analyzed. At the onset of the economic recession in 1998, a significant increase was observed in overall age-standardized mortality rates and sex-/age-specific populations, except for those aged 60 or older. The difference in trend between before and after implementation of the Suicide Prevention Act was not significant for overall or for any stratified populations. After the onset of the Tōhoku earthquake and tsunami of 2011, mortality rates declined for overall and for sex-/age-specific populations. Limitations: No information was available on what could have led to each suicide. Conclusion: The decline in mortality rates may be due to a significant and recent natural disaster. Further studies are needed to clarify plausible mechanisms for the decline in suicide rates following the Tōhoku disaster.

  77. Midlife Psychological Well-Being and its Impact on Cognitive Functioning Later in Life: An Observational Study Using a Female British Birth Cohort International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Atsushi Nishida, Marcus Richards

    Journal of Alzheimer's Disease　72　(3)　835-843　2019/10/17

    DOI： 10.3233/JAD-190590 　

  78. The association between role model presence and self-regulation in early adolescence: A cross-sectional study International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Kaori Endo, Shuntaro Ando, Yuko Morimoto, Shinya Fujikawa, Sho Kanata, Yusuke Takahashi, Toshi A. Furukawa, Marcus Richards, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    PLoS ONE　14　(9)　e0222752　2019/09/19

    DOI： 10.1371/journal.pone.0222752 　

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    PURPOSE: Self-regulation is the capacity to regulate attention, emotion, and behaviour to pursue long-term goals. The current study examined the associations between role model presence and self-regulation during early adolescence, controlling for hopefulness, using a large population-based data set from the Tokyo Teen Cohort study. METHODS: Adolescents, aged 12 years, identified a role model using a single item on a paper questionnaire: 'Who is the person you most look up to?' Level of hopefulness was also assessed using a single question: 'To what extent do you feel hopeful about the future of your life?' Trained investigators evaluated self-regulation. RESULTS: Of 2550 adolescents, 2279 (89.4%) identified a role model. After adjusting for level of hopefulness, identifying a role model was associated with higher levels of self-regulation in comparison to indications of no role model. Hopeful future expectations were also associated with higher self-regulation; however, the beta coefficient was smaller than role model presence in the multivariate linear regression analysis. CONCLUSIONS: Role model presence was significantly associated with higher self-regulation among early adolescents. Educational environments should focus on support for adolescents with no role models.

  79. Care preferences of healthy, middle‐aged adults in Japan and the USA if they acquired dementia: A cross‐sectional observational study International-journal Peer-reviewed

    Miharu Nakanishi, Yuki Miyamoto, Taeko Nakashima, Yumi Shindo, Atsushi Nishida

    Geriatrics & Gerontology International　19　(8)　829-833　2019/08/08

    DOI： 10.1111/ggi.13729 　

  80. Effectiveness of 1‐day trauma‐informed care training programme on attitudes in psychiatric hospitals: A pre–post study International-journal Peer-reviewed

    Junko Niimura, Miharu Nakanishi, Yasuyuki Okumura, Masashi Kawano, Atsushi Nishida

    International Journal of Mental Health Nursing　28　(4)　980-988　2019/08/01

    DOI： 10.1111/inm.12603 　

  81. Response inhibition and anxiety in adolescents: Results from a population-based community sample. International-journal Peer-reviewed

    Yudai Iijima, Yasuyuki Okumura, Syudo Yamasaki, Shuntaro Ando, Miharu Nakanishi, Shinsuke Koike, Kaori Endo, Yuko Morimoto, Sho Kanata, Shinya Fujikawa, Yu Yamamoto, Toshi A Furukawa, Mariko Hiraiwa-Hasegawa, Kiyoto Kasai, Atsushi Nishida

    Journal of affective disorders　246　89-95　2019/03/01

    DOI： 10.1016/j.jad.2018.12.010 　

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    BACKGROUND: Anxiety disorders are prevalent among adolescents; however, without objective behavioral markers, anxiety disorders in adolescent populations may often go undiagnosed. Response inhibition is considered as a possible behavioral marker, based on the results with two-gate design, which can aid in early detection of anxiety disorders. The aim of this study was to investigate the relationship between response inhibition and anxiety using a large-scale population-based adolescent sample with single-gate design. METHODS: We used data from the Tokyo Teen Cohort study which was a population-based survey in adolescence. Anxiety was assessed by the Child Behavior Checklist answered by primary caregivers. Response inhibition was measured using the Go/No-Go task. We estimated Pearson's correlation coefficient to test the relationship between response inhibition and anxiety. RESULTS: A total of 2,434 adolescents aged 11-13 years were included in our analyses. We found a significant but weak correlation between response inhibition and adolescent anxiety (r = 0.07, confidence interval 0.03-0.11, p < 0.001). Similar results were shown in most of subgroups according to gender, age, and intelligence. LIMITATIONS: The primary outcome was assessed only via parent-reported questionnaire, leading to potential informant bias. CONCLUSIONS: Response inhibition may not be considered as a suitable behavioral marker of adolescent anxiety.

  82. Inhibited autonomy for promoting physical health: qualitative analysis of narratives from persons living with severe mental illness International-journal Peer-reviewed

    Miharu Nakanishi, Shintaro Tanaka, George Kurokawa, Shuntaro Ando, Syudo Yamasaki, Masato Fukuda, Kiyohisa Takahashi, Takuya Kojima, Atsushi Nishida

    BJPsych Open　5　(1)　e10　2019/01/10

    Publisher: Royal College of Psychiatrists

    DOI： 10.1192/bjo.2018.77 　

    eISSN： 2056-4724

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    Background Autonomy is a key factor in the reduction of inequitable physical healthcare among people with severe mental illness compared with the general population. Aims To clarify the critical mechanism underlying autonomy in physical health promotion based on the perspectives of people with severe mental illness. Method We employed a conventional content analysis of narrative data from the Healthy Active Lives in Japan (HeAL Japan) workshop meetings. Results ‘Inhibited autonomy’ was extracted as a central component and shaped by the users’ experiences, both in a healthcare setting and in real life. This component emerged based on the lack of an empowerment mechanism in psychiatric services. Conclusions A barrier to the encouragement of autonomy in physical health promotion was found in current psychiatric services. An effective strategy should be explored to foster an empowerment mechanism in psychiatric and mental health services. Declaration of interest None.

  83. In-hospital dementia-related deaths following implementation of the national dementia plan: observational study of national death certificates from 1996 to 2016 International-journal Peer-reviewed

    Miharu Nakanishi, Syudo Yamasaki, Atsushi Nishida

    BMJ Open　8　(12)　e023172　2018/12/16

    Publisher: {BMJ}

    DOI： 10.1136/bmjopen-2018-023172 　

  84. Dementia behaviour management programme at home: impact of a palliative care approach on care managers and professional caregivers of home care services International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Kaori Endo, Kayo Hirooka, Taeko Nakashima, Yuko Morimoto, Eva Granvik, Lennart Minthon, Katarina Nägga, Atsushi Nishida

    Aging & Mental Health　22　(8)　1057-1062　2018/10/01

    DOI： 10.1080/13607863.2017.1332160 　

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    OBJECTIVES: Care managers and professional caregivers of home care services are sometimes unaware of the psychosocial approaches to the challenging behaviour of dementia. Therefore, we developed a Behaviour Analytics & Support Enhancement (BASE) programme. We investigated the effects of the programme on the attitudes towards dementia care among professionals. METHOD: Forty-six participants in Japan received training in August 2016. The ongoing monitoring and assessment system was introduced to the participants for repeated measures of challenging behaviour. A 1-day follow-up meeting for debriefing was also performed after two months. A baseline and follow-up questionnaire survey was administered to the participating caregivers using a Japanese version of the Approaches to Dementia Questionnaire (ADQ) and the Zarit Burden Interview (ZBI). RESULTS: A significant improvement was observed in the total ADQ score among the participating caregivers from baseline to follow-up assessment. There was no significant difference between the baseline and follow-up assessment in the ZBI scores. In the follow-up meeting, several participants reported challenges and suggested solutions in facilitating a discussion on an action plan among professionals from various organizations. CONCLUSION: The implementation of the programme resulted in enhanced attitudes towards dementia care among the participants without an increased burden of care. Future studies should examine the programme's effectiveness on the challenging behaviour of persons with dementia.

  85. Dementia care competence among care professionals and reduced challenging behavior of home-dwelling persons with dementia: A pre- and post-intervention data analysis International-journal Peer-reviewed

    Miharu Nakanishi, Kayo Hirooka, Yasuaki Imai, Shintaro Inoue, Yukio Yukari, Chie Katayama, Yuki Miyamoto, Yumi Shindo, Hideki Ueno, Junichiro Toya, Yosuke Takano, Atsushi Nishida

    Journal of Alzheimer's Disease　64　(2)　515-523　2018/06/19

    Publisher:

    DOI： 10.3233/JAD-171077 　

    ISSN： 1387-2877

    eISSN： 1875-8908

  86. Hospital death in dementia patients and regional provision of palliative and end-of-life care: National patient data analysis International-journal Peer-reviewed

    Kayo Hirooka, Miharu Nakanishi, Hiroki Fukahori, Atsushi Nishida

    Cogent Medicine　5　(1)　1483097-1483097　2018/06/06

    Publisher: Informa UK Limited

    DOI： 10.1080/2331205X.2018.1483097 　

    eISSN： 2331-205X

  87. Dementia and risk of 30-day readmission in older adults after discharge from acute care hospitals International-journal Peer-reviewed

    Nobuo Sakata, Yasuyuki Okumura, Kiyohide Fushimi, Miharu Nakanishi, Asao Ogawa

    Journal of the American Geriatrics Society　66　(5)　871-878　2018/05/16

    Publisher: Blackwell Publishing Inc.

    DOI： 10.1111/jgs.15282 　

    ISSN： 1532-5415 0002-8614

  88. The Association between Quality Improvement Initiatives in Dementia Care and Supportive Psychosocial Work Environments in Nursing Homes International-journal Peer-reviewed

    Miharu Nakanishi, Maki Tei-Tominaga

    Healthcare　6　(2)　44　2018/05/08

    DOI： 10.3390/healthcare6020044 　

  89. Purpose in life and tobacco use among community-dwelling mothers of early adolescents. International-journal International-coauthorship Peer-reviewed

    Yuko Morimoto, Syudo Yamasaki, Shuntaro Ando, Shinsuke Koike, Shinya Fujikawa, Sho Kanata, Kaori Endo, Miharu Nakanishi, Stephani L Hatch, Marcus Richards, Kiyoto Kasai, Mariko Hiraiwa-Hasegawa, Atsushi Nishida

    BMJ open　8　(4)　e020586　2018/04/20

    DOI： 10.1136/bmjopen-2017-020586 　

    ISSN： 2044-6055

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    OBJECTIVES: The rising prevalence of tobacco use and tobacco-attributable deaths among women is of worldwide concern. In particular, smoking prevention for mothers in early midlife is a significant international public health goal. A higher sense of purpose in life (PIL) is thought to reduce detrimental health behaviours. However, little is known about the association between a sense of PIL and tobacco use. This study investigates this association among community-dwelling mothers of early adolescents. DESIGN: This population-based cross-sectional study uses a self-reported questionnaire from the Tokyo Early Adolescence Survey, a large community-based survey conducted in Japan between 2012 and 2015. SETTING: Participants were randomly recruited from the resident registries of three municipalities in Tokyo, Japan. PARTICIPANTS: A total of 4478 children and their primary parents participated. Responses from 4063 mothers with no missing data were analysed (mean age=42.0 years (SD=4.2)). MEASURES: Participants' tobacco use, including the number of cigarettes smoked per day, was documented using a questionnaire. PIL was assessed using a Purpose in Life scale derived from Ryff's Psychological Well-Being Scale. RESULTS: Greater PIL was associated with a decreased likelihood of tobacco use, even when adjusted for confounders (OR=0.80, 95% CI 0.70 to 0.91). Multinomial logistic regression analyses revealed that PIL was inversely associated with tobacco consumption among mothers. These associations remained after controlling for psychological distress, socioeconomic factors and frequency of alcohol consumption among moderate to heavy smokers (OR=0.70, 95% CI 0.57 to 0.86), while attenuated among light smokers. CONCLUSIONS: Increasing PIL may be a valuable intervention for reducing tobacco use among women in early midlife. This study can contribute to our understanding of the psychology of smoking behaviour and shed light on the targeted intervention to reduce tobacco use among early midlife mothers.

  90. Psychosocial behaviour management programme for home-dwelling people with dementia: A cluster-randomized controlled trial International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Kaori Endo, Kayo Hirooka, Eva Granvik, Lennart Minthon, Katarina Nägga, Atsushi Nishida

    International Journal of Geriatric Psychiatry　33　(3)　495-503　2018/03/01

    DOI： 10.1002/gps.4784 　

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    Little is known about the effectiveness of a psychosocial behaviour management programme on home-dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home-dwelling people with dementia. METHODS: A cluster-randomized controlled trial was conducted with home care providers from 3 different districts in Tokyo. Each provider recruited persons with dementia aged 65 years or older to receive home care in the BASE programme in August 2016. An online monitoring and assessment system was introduced to the intervention group for repeated measures of challenging behaviour with a total score of the Neuropsychiatric Inventory. Care professionals in both the intervention and control groups evaluated challenging behaviour of persons with dementia at baseline (September 2016) and follow-up (February 2017). RESULTS: A majority of persons with dementia had Alzheimer disease (59.3%). One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. Multilevel modelling revealed a significant reduction in challenging behaviour in the intervention group after 6 months (mean score, 18.3 to 11.2) compared with that of the control group (11.6 to 10.8; P < .05). CONCLUSION: The implementation of the BASE programme resulted in a reduction of challenging behaviour of home-dwelling people with dementia. Future research should examine the long-term effects of behaviour management programmes on behaviour, nursing home placement, and hospital admission of home-dwelling people with dementia.

  91. The influence of supportive and ethical work environments on work-related accidents, injuries, and serious psychological distress among hospital nurses. International-journal Peer-reviewed

    Maki Tei-Tominaga, Miharu Nakanishi

    International Journal of Environmental Research and Public Health　15　(2)　240　2018/01/31

    Publisher: MDPI AG

    DOI： 10.3390/ijerph15020240 　

    ISSN： 1660-4601 1661-7827

  92. Regional supply of outreach service and length of stay in psychiatric hospital among patients with schizophrenia: National case mix data analysis in Japan International-journal Peer-reviewed

    Junko Niimura, Miharu Nakanishi, Syudo Yamasaki, Atsushi Nishida

    Psychiatry Research　258　295-298　2017/12/01

    DOI： 10.1016/j.psychres.2017.08.067 　

    ISSN： 0165-1781

  93. Quality of care for people with dementia and professional caregivers' perspectives regarding palliative care in Japanese community care settings International-journal Peer-reviewed

    Miharu Nakanishi, Kayo Hirooka, Yuko Morimoto, Atsushi Nishida

    International Journal of Geriatric Psychiatry　32　(12)　1342-1351　2017/12/01

    DOI： 10.1002/gps.4620 　

    ISSN： 0885-6230

    eISSN： 1099-1166

  94. Physical restraint to patients with dementia in acute physical care settings: effect of the financial incentive to acute care hospitals. International-journal Peer-reviewed

    Nakanishi M, Okumura Y, Ogawa A

    International psychogeriatrics　30　(7)　991-1000　2017/11/10

    DOI： 10.1017/s104161021700240x 　

  95. National suicide prevention, local mental health resources, and suicide rates in Japan International-journal Peer-reviewed

    Miharu Nakanishi, Kaori Endo

    Crisis　38　(6)　384-392　2017/11/01

    DOI： 10.1027/0227-5910/a000469 　

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    BACKGROUND: Suicide rates in Japan are relatively high in OECD countries. A national fund to help local authorities implement suicide prevention programs was launched in 2009. The national suicide prevention project was transferred from the Cabinet Office to the Ministry of Health, Labor, and Welfare on April 2016, with a greater focus on mental health promotion by local governments. AIMS: The aim of the present study was to (a) identify local authorities' implementation of suicide prevention programs in terms of local health policies, and (b) examine the associations between local health resources and suicide rates in Japan. METHOD: We investigated the types of programs implemented under the fund, and correlations with authorities' sociodemographic characteristics and mental health and welfare resources. RESULTS: A majority of authorities implemented general suicide prevention programs. More focused programs addressing issues such as mental health in the workplace, alcohol problems, and attempted suicide were less frequently implemented. There were significantly fewer suicides in health regions with a higher ratio of psychiatrists to residents or a lower ratio of psychiatric beds. LIMITATIONS: A causal relationship between suicide rates and characteristics of local authorities cannot be inferred from the data. CONCLUSION: A community mental health system that operated in parallel to the current system may result in fewer inpatients and a reduction in Japan's suicide rate.

  96. Factors associated with end-of-life by home-visit nursing-care providers in Japan International-journal Peer-reviewed

    Miharu Nakanishi, Junko Niimura, Atsushi Nishida

    Geriatrics & Gerontology International　17　(6)　991-998　2017/07/07

    DOI： 10.1111/ggi.12822 　

    ISSN： 1444-1586

    eISSN： 1447-0594

  97. Sex differences in auditory verbal hallucinations in early, middle and late adolescence: results from a survey of 17 451 Japanese students aged 12-18 years. International-journal Peer-reviewed

    Yoko Morokuma, Kaori Endo, Atushi Nishida, Syudo Yamasaki, Shuntaro Ando, Yuko Morimoto, Miharu Nakanishi, Yuji Okazaki, Toshi A Furukawa, Shigeru Morinobu, Shinji Shimodera

    BMJ open　7　(5)　e015239　2017/06/01

    DOI： 10.1136/bmjopen-2016-015239 　

    ISSN： 2044-6055

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    OBJECTIVES: Women have higher rates of auditory verbal hallucinations (AVH) than men; however, less is known about sex differences in the prevalence of AVH in early, middle and late adolescence. We sought to elucidate the differences in the prevalence of AVH and to examine the degree to which these differences could be explained by differences in levels of depressive symptoms. DESIGN: We used a cross-sectional design and a self-reported questionnaire. SETTING: Participants were recruited from public junior and senior high schools in Tsu, Mie Prefecture and Kochi Prefecture, Japan. PARTICIPANTS: In total, 19 436 students were contacted and 18 250 participated. Responses from 17 451 students with no missing data were analysed (aged 12-18 years, Mage=15.2 years (SD=1.7), 50.6% girls). MEASURES: AVH were assessed through one of four items adopted from the schizophrenia section of the Japanese version of the Diagnostic Interview Schedule for Children. Depressive symptoms were assessed using the 12-item General Health Questionnaire. RESULTS: The prevalence of AVH was 7.0% among early adolescents (aged 12-13 years), 6.2% among middle adolescents (aged 14-15 years) and 4.8% among late adolescents (aged 16-18 years). Being female was significantly associated with a higher prevalence of AVH through adolescence (OR=1.71, 95% CI 1.31 to 2.23 in early adolescence; OR=1.42, 95% CI 1.14 to 1.76 in middle adolescence; OR=1.52, 95% CI 1.23 to 1.87 in late adolescence); however, these differences became non-significant after adjusting for depressive symptoms (OR=1.21, 95% CI 0.92 to 1.60; OR=1.00, 95% CI 0.80 to 1.25; OR=1.16, 95% CI 0.93 to 1.44, respectively). CONCLUSIONS: Sex differences in auditory hallucinations are seen in both adult and youth populations. The higher rates of auditory verbal hallucinations seen in girls may be secondary to the differences in the rate of depressive symptoms.

  98. Death of dementia patients in psychiatric hospitals and regional supply of psychiatric services: study of the national data from 1996 to 2014 in Japan. International-journal Peer-reviewed

    Miharu Nakanishi, Junko Niimura, Shudo Yamasaki, Atsushi Nishida

    Journal of Alzheimer's Disease　56　(2)　817-824　2017/01/24

    DOI： 10.3233/JAD-160935 　

    ISSN： 1387-2877

    eISSN： 1875-8908

  99. The Basic Act for Suicide Prevention: Effects on longitudinal trend in deliberate self-harm with reference to national suicide data for 1996–2014 International-journal Peer-reviewed

    Miharu Nakanishi, Kaori Endo, Shuntaro Ando

    International Journal of Environmental Research and Public Health　14　(1)　104　2017/01/21

    DOI： 10.3390/ijerph14010104 　

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    A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014-a nationally representative cross-sectional survey of inpatient care every 3 years-were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%). The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5%) relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes.

  100. Challenges following discharge from acute psychiatric inpatient care in Japan: patients’ perspectives International-journal Peer-reviewed

    Junko Niimura, Michika Tanoue, Miharu Nakanishi

    Journal of Psychiatric and Mental Health Nursing　23　(9-10)　576-584　2016/11/01

    DOI： 10.1111/jpm.12341 　

    ISSN： 1351-0126

    eISSN： 1365-2850

  101. Regional supply of nursing home and hospital beds determine discharge destination of nursing home residents in Japan. International-journal Peer-reviewed

    Miharu Nakanishi, Junko Niimura, Kaori Endo, Atsushi Nishida

    Journal of the American Medical Directors Association　17　(7)　672.e1-672.e5　2016/07/01

    DOI： 10.1016/j.jamda.2016.04.024 　

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    OBJECTIVES: Japanese special nursing homes provide permanent residence to elderly people under the public long-term care insurance program. However, a quarter of discharges occur via death in hospital, and a fifth occur via admission to hospital. The objective was to identify factors associated with discharge destinations for residents of Japanese special nursing homes. DESIGN: A retrospective design for data collected in 2007, 2010, and 2013. SETTING: We used data from the Survey of Institutions and Establishments for Long-Term Care, which is a nationally representative cross-sectional survey that assessed discharge from special nursing homes in September every 3 years. PARTICIPANTS: There were 2426 discharged residents included in the analysis. MEASUREMENTS: Discharge destination was categorized as death at facility, death in hospital, hospital admission, and another care setting. Multivariate multinomial logistic regression analysis was conducted with discharge destination as the dependent variable. RESULTS: Of the 2426 discharged residents included in the analysis, 874 (36.0%) were deceased at the facility, 773 (31.9%) were deceased in hospital, 652 (26.9%) were admitted to hospital, and 127 (5.2%) were admitted to another care setting. Residents of facilities in the regions with fewer nursing home beds or more hospital beds were more likely to be discharged via admittance to hospital or another care setting relative to being deceased at the facility. CONCLUSION: The regional supply of nursing home and hospital beds could have affected end-of-life care locations for residents of special nursing homes. To promote end-of-life care in special nursing homes, regional supply of nursing home beds should be reinforced while controlling oversupply of hospital beds.

  102. Japanese care location and medical procedures for people with dementia in the last month of life International-journal Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Yumi Shindo, Junko Niimura, Atsushi Nishida

    Journal of Alzheimer's Disease　51　(3)　747-755　2016/03/30

    DOI： 10.3233/JAD-150898 　

    ISSN： 1387-2877

    eISSN： 1875-8908

  103. Palliative care for advanced dementia in Japan: knowledge and attitudes International-journal Peer-reviewed

    Miharu Nakanishi, Yuki Miyamoto

    British Journal of Nursing　25　(3)　146-155　2016/02/15

    Publisher: MA Healthcare Ltd

    DOI： 10.12968/bjon.2016.25.3.146 　

    ISSN： 0966-0461

  104. Discharge destination of dementia patients who undergo intermediate care at a facility International-journal Peer-reviewed

    Miharu Nakanishi, Yumi Shindo, Junko Niimura

    Journal of the American Medical Directors Association　17　(1)　92.e1-92.e7　2016/01/01

    DOI： 10.1016/j.jamda.2015.10.018 　

    ISSN： 1525-8610

    eISSN： 1538-9375

  105. Documentation of nursing home resident’s preferences regarding end-of-life care in Japan: Does the documentation serve as an advanced directive in care planning. International-journal Peer-reviewed

    Miharu Nakanishi, Yuki Miyamoto

    European Joural for Person Centered Healthcare　3　(3)　309-317　2015/09/01

    DOI： 10.5750/ejpch.v3i3.982 　

  106. A Japanese booklet about palliative care for advanced dementia in nursing homes. International-journal International-coauthorship Peer-reviewed

    Miharu Nakanishi, Yuki Miyamoto, Carol O Long, Marcel Arcand

    International Journal of Palliative Nursing　21　(8)　385-391　2015/09/01

    Publisher: MA Healthcare Ltd

    DOI： 10.12968/ijpn.2015.21.8.385 　

    ISSN： 1357-6321

  107. “Ageing in Place” policy in Japan: association between the development of an integrated community care system and the number of nursing home placements under the public long-term care insurance program among municipal governments International-journal Peer-reviewed

    Miharu Nakanishi, Sayuri Shimizu, Takashi Murai, Atsushi Yamaoka

    Ageing International　40　(3)　248-261　2015/09/01

    Publisher: Springer New York LLC

    DOI： 10.1007/s12126-014-9215-x 　

    ISSN： 1936-606X 0163-5158

  108. Association between length of hospital stay and implementation of discharge planning in acute psychiatric inpatients in Japan International-journal Peer-reviewed

    Miharu Nakanishi, Junko Niimura, Michika Tanoue, Motoe Yamamura, Toyoaki Hirata, Nozomu Asukai

    International Journal of Mental Health Systems　9　23　2015/05/30

    DOI： 10.1186/s13033-015-0015-9 　

    ISSN： 1752-4458

  109. Japanese Public Long-Term Care Insured: Preferences for Future Long-Term Care Facilities, Including Relocation, Waiting Times, and Individualized Care International-journal Peer-reviewed

    Kanae Sawamura, Hiroshi Sano, Miharu Nakanishi

    JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION　16　(4)　350.e9-350.e20　2015/04/01

    DOI： 10.1016/j.jamda.2015.01.082 　

    ISSN： 1525-8610

    eISSN： 1538-9375

  110. National strategy for suicide prevention in Japan: The impact of a national fund on the progress of developing systems for suicide prevention and implementing initiatives among local authorities International-journal Peer-reviewed

    Miharu Nakanishi, Takeshi Yamauchi, Tadashi Takeshima

    Psychiatry and Clinical Neurosciences　69　(1)　55-64　2015/01/01

    DOI： 10.1111/pcn.12222 　

    ISSN： 1323-1316

    eISSN： 1440-1819

  111. Features of the Japanese national dementia strategy in comparison with international dementia policies: how should a national dementia policy interact with the public health and social care systems? International-journal Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima

    Alzheimer's & Dementia　10　(4)　468-476　2014/07/01

    DOI： 10.1016/j.jalz.2013.06.005 　

    ISSN： 1552-5260

    eISSN： 1552-5279

  112. Percutaneous endoscopic gastrostomy (PEG) tubes are placed in elderly adults in Japan with advanced dementia regardless of expectation of improvement in quality of life International-journal Peer-reviewed

    Miharu Nakanishi, Keiko Hattori

    The Journal of Nutrition, Health & Aging　18　(5)　503-509　2014/05/01

    DOI： 10.1007/s12603-014-0011-9 　

    ISSN： 1279-7707

    eISSN： 1760-4788

  113. Health care and personal care needs among residents in nursing homes, group homes, and congregate housing in Japan: why does transition occur, and where can the frail elderly establish a permanent residence? International-journal Peer-reviewed

    Miharu Nakanishi, Keiko Hattori, Taeko Nakashima, Kanae Sawamura

    Journal of the American Medical Directors Association　15　(1)　76e1-76e6　2014/01/01

    DOI： 10.1016/j.jamda.2013.07.006 　

    ISSN： 1525-8610

    eISSN： 1538-9375

  114. Systems development and difficulties in implementing procedures for elder abuse prevention among private community general support centers in Japan International-journal Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Yukako Yamaoka, Keiko Hada, Hideaki Tanaka

    Journal of Elder Abuse & Neglect　26　(1)　31-43　2014/01/01

    DOI： 10.1080/08946566.2013.784077 　

    ISSN： 0894-6566 1540-4129

  115. Community-based system, reports, and substantiated cases of elder abuse: disparities between municipalities and relating factors in Japan International-journal Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Nobuko Sakata, Noriko Tsuchiya, Kaoru Takizawa

    Journal of Aging & Social Policy　25　(3)　234-247　2013/07/09

    DOI： 10.1080/08959420.2013.793086 　

    ISSN： 0895-9420

  116. Provision of individualized care and built environment of nursing homes in Japan International-journal Peer-reviewed

    Kanae Sawamura, Taeko Nakashima, Miharu Nakanishi

    ARCHIVES OF GERONTOLOGY AND GERIATRICS　56　(3)　416-424　2013/05/01

    DOI： 10.1016/j.archger.2012.11.009 　

    ISSN： 0167-4943

  117. Priority for elderly persons with behavioral and psychological symptoms of dementia on waiting lists for placement in nursing homes in Japan: do nursing homes change priorities based on their own guidelines? International-journal Peer-reviewed

    Miharu Nakanishi, Keiko Hattori, Taeko Nakashima, Kanae Sawamura

    Journal of the American Medical Directors Association　13　(9)　794-799　2012/11/01

    DOI： 10.1016/j.jamda.2012.08.010 　

    ISSN： 1525-8610

  118. Evaluation of the booklet on end-of-life care for residents with dementia by staff of special nursing homes in Japan : Survey on attitudes towards palliative care for nursing home residents with dementia International-coauthorship Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Marcel Arcand, Cees M.P.M. Hertogh, Jenny T. van, der Steen

    Journal of Japanese Society for Dementia Care　11　(2)　477-486　2012/07/20

    Publisher:

    ISSN： 1882-0255

  119. Quality of life of residents with dementia in a group-living situation: An approach to creating small, homelike environments in traditional nursing homes in Japan. Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Kanae Sawamura

    Japanese Journal of Public Health　59　(1)　3-10　2012/01/15

    Publisher: Japanese Society of Public Health

    DOI： 10.11236/jph.59.1_3 　

    ISSN： 0546-1766

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    Objectives Group living is an approach that can create small, homelike environments in traditional nursing homes in Japan. The aim of the present study was to examine quality of life (QOL) of residents with dementia in group-living situations.<br/>Methods The group-living group consisted of facilities that formed residential units. Each unit had a common area and stable staff assignments. The control group consisted of facilities that did not form residential units. The quality of life instrument for Japanese elderly with dementia (QLDJ) scale was used to rate QOL by direct care workers of 616 residents with dementia from 173 facilities in the group-living group and 750 residents from 174 facilities in the control group. QOL was based on the following subscales: interacting with surroundings; expressing oneself; and experiencing minimal negative behavior.<br/>Results Multilevel regression analyses demonstrated a significantly greater QOL with respect to interacting with surroundings, expressing oneself, and experiencing minimal negative behavior for residents with dementia in the group-living group compared to the control group, as measured by the QLDJ. The total QLDJ score was also significantly higher for the group-living group.<br/>Conclusion The results suggest improved QOL of residents with dementia under group-living situations. Future studies should examine the effect of group-living on QOL of residents with dementia using a cohort design, following residents longitudinally from admission.

  120. Job role quality and intention to leave current facility and to leave profession of direct care workers in Japanese residential facilities for elderly International-journal Peer-reviewed

    Miharu Nakanishi, Hisato Imai

    Archives of Gerontology and Geriatrics　54　(1)　102-108　2012/01/01

    DOI： 10.1016/j.archger.2010.12.017 　

    ISSN： 0167-4943

  121. Study on the relationship between efforts by municipalities and supports by prefectures concerning prevention of elder abuse Peer-reviewed

    7　(1)　72-81　2011/03/01

    Publisher:

    ISSN： 1880-1838

  122. Research on system for the elderly abuse prevention among small-scale municipal governments in Japan Peer-reviewed

    7　(1)　139-149　2011/03/01

    Publisher:

    ISSN： 1880-1838

  123. Disparities in systems development for elder abuse prevention among municipalities in Japan: implications for strategies to help municipalities develop community systems. International-journal Peer-reviewed

    Miharu Nakanishi, Taeko Nakashima, Tatsuo Honda

    Social Science & Medicine　71　(2)　400-404　2010/07/01

    DOI： 10.1016/j.socscimed.2010.03.046 　

    ISSN： 0277-9536

  124. Development of a clinical pathway for long-term inpatients with schizophrenia International-journal Peer-reviewed

    Miharu Nakanishi, Kanae Sawamura, Sayaka Sato, Yutaro Setoya, Nobuo Anzai

    Psychiatry and Clinical Neurosciences　64　(1)　99-103　2010/01/20

    DOI： 10.1111/j.1440-1819.2009.02040.x 　

    ISSN： 1323-1316

    eISSN： 1440-1819

  125. Process of decision making and end-of-life care for patients with dementia in group homes in Japan. International-journal Peer-reviewed

    Miharu Nakanishi, Tatsuo Honda

    Archives of Gerontology and Geriatrics　48　(3)　296-299　2009/05/01

    DOI： 10.1016/j.archger.2008.02.009 　

    ISSN： 0167-4943

  126. Impact of the elder abuse prevention and care giver support law on system development among municipal governments in Japan. International-journal Peer-reviewed

    Miharu Nakanishi, Yumiko Hoshishiba, Nobuyuki Iwama, Tomoko Okada, Etsuko Kato, Hiroshi Takahashi

    Health Policy　90　(2-3)　254-261　2009/05/01

    DOI： 10.1016/j.healthpol.2008.10.009 　

    ISSN： 0168-8510

  127. Implementation of discharge planning in the care of hospitalized older adults : Focus on involvement of home care providers at hospitals Peer-reviewed

    NAKANISHI Miharu, NAGAE Hiroko, NAGATA Satoko, HATTORI Keiko, NIINO Yoshiko

    Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH)　55　(7)　456-464　2008/07/15

    Publisher: Japanese Society of Public Health

    DOI： 10.11236/jph.55.7_456 　

    ISSN： 0546-1766

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    Objectives&emsp;The present study was conducted to assess current implementation of discharge planning in the care of hospitalized older adults, and to examine the association between implementation and involvement of home care providers at hospitals.<br/>Methods&emsp;The subjects were 434 hospitals with 100 beds or more for general patients, nationwide. We conducted a questionnaire survey by mail of hospital staff responsible for the discharge planning, and assessed to what extent home care providers were associated with the implementation of discharge planning in the hospitals. The subjects were divided into two groups: an association group (138 hospitals) in which home care providers were associated with implementation in the hospitals, and a not-association group (296 hospitals). We compared the proportions of implementation of discharge planning between the two groups, and calculated odds-ratios. In the analysis, we controlled for affiliated institution and home care services.<br/>Results&emsp;The association group showed significantly higher proportions of implementation for 13 items in a total 24 items for discharge planning than the not-association group (range of odds-ratio: 2.430-5.497). The three highest odds ratios were observed for &ldquo;Arrangement and guidance for home care by outreach prior to discharge&rdquo; [OR=5.497, 95% confidence interval (CI): 2.604-11.602], &ldquo;Adjusting relationship between patient and family&rdquo; (OR=4.871, 95%CI: 1.323-17.930) and &ldquo;Refining medical and nursing care so as to be sustainable at home&rdquo; (OR=4.740, 95%CI: 1.825-12.311).<br/>Conclusions&emsp;The present study showed that hospitals with involvement of home care providers had higher proportions of implementation of discharge planning for hospitalized older adults concerning &ldquo;Arrangement and guidance for home care by outreach prior to discharge&rdquo;, &ldquo;Adjusting relationship between patient and family&rdquo;, &ldquo;Refining medical and nursing care so as to be sustainable at home&rdquo; and so on. Further study should examine the effect of discharge planning on length of stay, rate of readmission, patient and family member's satisfaction controlling for patient characteristics and hospital's role in the community.

  128. Addition of antipsychotics to medication regimens during schizophrenic inpatient care. International-journal Peer-reviewed

    Asuka Koyama, Hiroto Ito, Miharu Nakanishi, Kanae Sawamura, Teruhiko Higuchi

    Psychiatry and Clinical Neurosciences　62　(1)　56-64　2008/02/13

    DOI： 10.1111/j.1440-1819.2007.01776.x 　

    ISSN： 1323-1316

  129. Symptom dimensions and needs of care among patients with schizophrenia in hospital and the community. International-journal Peer-reviewed

    Miharu Nakanishi, Yutaro Setoya, Manami Kodaka, Hazuki Makino, Akio Nishimura, Keita Yamauchi, Masaru Mimura, Hisao Sato, Hiroshi Arata, Hidefumi Yukumi, Takashi Amagasa, Hideki Ueno, Yuki Miyamoto, Takuya Sugie, Nobuo Anzai

    Psychiatry and Clinical Neurosciences　61　(5)　495-501　2007/09/14

    DOI： 10.1111/j.1440-1819.2007.01698.x 　

    ISSN： 1323-1316

  130. Nurses’ collaboration with physicians in managing medication improves patient outcome in acute psychiatric care. International-journal Peer-reviewed

    Miharu Nakanishi, Asuka Koyama, Hiroto Ito, Hiroshi Kurita, Teruhiko Higuchi

    Psychiatry and Clinical Neurosciences　60　(2)　196-203　2006/03/14

    DOI： 10.1111/j.1440-1819.2006.01486.x 　

    ISSN： 1323-1316

    eISSN： 1440-1819

  131. 養護教諭の職業性ストレスと精神的健康--養護教諭の職業性ストレス尺度の作成 Peer-reviewed

    中西 三春

    学校メンタルヘルス　7　25-33　2005/03

    Publisher: 日本学校メンタルヘルス学会

    DOI： 10.24503/jasmh.7.0_25 　

    ISSN： 1344-5944

  132. 私立女子中高等学校における保護者のスクールカウンセリング活動に対する要望の変化 : スクールカウンセラーが導入された直後と1年後との比較 Peer-reviewed

    中西 三春, 黒沢 幸子, 森 俊夫

    こころの健康 : 日本精神衛生学会誌　19　(1)　61-72　2004/06/10

    Publisher: 日本精神衛生学会

    DOI： 10.11383/kokoronokenkou1986.19.61 　

    ISSN： 0912-6945

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    本研究は, 保護者用包括的ニーズ評価尺度CAN-SCS (P-version) を用いて, スクールカウンセラーの活動内容に対する保護者の要望の変化を明らかにすることを目的として行われた。2000年度4月よりスクールカウンセラーが配置された都内の私立女子中高等学校B校の協力により, 同校の保護者を対象として2000年度 (スクールカウンセラーの導入直後) と2001年度 (1年後) の2時点で無記名式の質問紙調査を行った。回収率は2000年度が66.2%(789/1192), 2001年度が47.7%(563/1178) であった。2001年度の回答者のうち, 「2000年度も調査に回答しましたか」という項目で「はい」と回答し, かつ2000年度のデータと照合して同定できた213人を本研究の分析対象とした。調査の結果, 1年間のスクールカウンセリング活動に対する保護者の評価は「分からない」という回答が多く, もっとも評価の得点が高かったのは「カウンセラー室の知られている程度」であった。この1年間はスクールカウンセラーの存在が保護者に認識されるようになるまでの期間であったと考えられた。2000年度と比べて2001年度の保護者の要望が高くなった活動内容は, 生徒集団への援助や地域との連携など, 2000年度の段階では要望が低かったものである傾向がみられた。このことから, 1年間のスクールカウンセリング活動を通してスクールカウンセラーの役割像が広がったことが示唆された。全体的にスクールカウンセラーに対する要望が高くなった保護者は, スクールカウンセラーに対する関心が高かった者であった。

  133. スクールカウンセラーの活動内容に対する保護者のニーズ : 私立女子中高等学校2校による結果報告 Peer-reviewed

    中西 三春, 森 俊夫

    こころの健康 : 日本精神衛生学会誌　17　(2)　66-74　2002/11/30

    Publisher: 日本精神衛生学会

    DOI： 10.11383/kokoronokenkou1986.17.2_66 　

    ISSN： 0912-6945

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    日本において, スクールカウンセラーに対する保護者のニーズを社会科学的に調査した研究はほとんどない。本研究は保護者用包括的ニーズ評価尺度CAN-SCS (P-version) を用いて, スクールカウンセラーの活動内容に対する保護者のニーズを明らかにする目的で行われた。都内の私立女子中高等学校A校とB校の2校から調査の同意が得られ, 同校の保護者を対象として質問紙調査を行った。どちらの学校も2000年度4月よりスクールカウンセラーが配置された。回答率はA校が67.9%(679/1000), B校が66.2%(789/1192) であった。質問紙の中でスクールカウンセラーの活動内容33項目を (1) 生徒に対する援助, (2) 教職員に対する援助, (3) 保護者に対する援助, および (4) 地域や外部機関との関わりに分けて示し, 保護者はそれぞれの活動内容について必要性の程度を評価した。本研究の結果, スクールカウンセラーの活動内容の多くが保護者に必要とされていた。保護者が求める活動内容は個別相談に留まらず, 教職員集団に対する援助や外部機関との連絡・連携といった活動に対しても一定のニーズが示された。スクールカウンセラーに多くの活動内容を求める保護者は, スクールカウンセラーに対する関心が高かった。スクールカウンセラーが保護者のニーズに対応した活動を行い保護者の関心を広げることで, 活動内容に対する保護者のニーズが広がることが示唆された。将来の研究の方向性として, 対象を広げ検討すること, スクールカウンセラーの活動を経た保護者のニーズの変化を明らかにすることが望まれる。

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Misc. 39

  1. 特集 増え続ける“認知症”―その医療と介護 認知症の人本人を中心としたケアの実現に向けて Invited

    中西 三春

    月刊保険診療　80　(3)　30-34　2025/03/12

  2. 解説：認知症の緩和ケアの必要性 世界的潮流と日本の現状 Invited

    中西 三春

    看護　76　(13)　59-61　2024/10/20

  3. Life with a purpose rather than living for the sake of being healthy: the challenges and promises to reduce dementia risk in later life International-journal Invited

    Miharu Nakanishi, Atsushi Nishida

    International Psychogeriatrics　36　(10)　857-859　2024/10/01

    Publisher: Cambridge University Press (CUP)

    DOI： 10.1017/s1041610224000449 　

    ISSN： 1041-6102

    eISSN： 1741-203X

  4. 精神病症状と孤独感の縦断的関係:東京ティーンコホートスタディから

    遠藤香織, 山崎修道, 中西三春, DEVYLDER Jordan, 宇佐美慧, 宇佐美慧, 森本裕子, STANYON Daniel, 鈴木一浩, 宮下光弘, 新井誠, 藤川慎也, 金田渉, 安藤俊太郎, 長谷川眞理子, 笠井清登, 笠井清登, 西田淳志

    日本精神保健・予防学会学術集会プログラム・抄録集　25th　2022

  5. 生後3年間の母親の育児ストレスと思春期児童への母親の体罰の縦断的関連:母子手帳記録を用いた長期予後予測

    新村順子, 中西三春, 山崎修道, 安藤俊太郎, 金田渉, 藤川慎也, 森本裕子, 遠藤香織, 長谷川眞理子, 笠井清登, 西田淳志

    日本精神保健・予防学会学術集会プログラム・抄録集　25th　2022

  6. 外国人介護職の雇用に関する質的研究:高齢者介護施設における定着にむけた取り組み

    富永真己, 田中真佐恵, 杉山智子, 矢吹知之, 中西三春

    日本衛生学雑誌(Web)　77　(Supplement)　2022

    ISSN： 1882-6482

  7. 高齢者介護施設のケア従事者における外国人介護職の受け入れへの期待と不安の実態

    富永真己, 田中真佐恵, 矢吹知之, 中西三春

    厚生の指標　68　(12)　1-8　2021/10

    Publisher: (一財)厚生労働統計協会

    ISSN： 0452-6104

  8. 急性期精神科医療における患者のNew long stayの要因と防止プログラム 精神科長期入院患者の退院後の転帰に関するシステマティックレビュー

    佐藤 さやか, 中西 三春, 小川 亮, 阿部 真貴子, 安間 尚徳, 河野 稔明, 五十嵐 百花, 山口 創生

    精神神経学雑誌　(2021特別号)　S432-S432　2021/09

    Publisher: (公社)日本精神神経学会

    ISSN： 0033-2658

  9. Numerical targets in action plan on suicide prevention developed by prefectures and designated cities in Japan

    41　(1)　25-31　2021/03

    Publisher: 日本自殺予防学会

    ISSN： 1883-6046

  10. エビデンスに基づいた認知症予防,ケア,社会的包摂 (特集 認知症施策推進大綱と共生と予防)

    中西 三春

    日本認知症ケア学会誌 = Journal of Japanese Society for Dementia Care　19　(4)　634-643　2021

    Publisher: 日本認知症ケア学会 ; [2005]-

    ISSN： 1882-0255

  11. A case-study of practical initiatives related to social capital in the workplace at four long-term care facilities for the elderly

    8　(1)　27-35　2020/03/31

    ISSN： 2187-624X

  12. To Stop Hindering Persons with Serious Mental Illness in Their Recovery Invited

    Miharu Nakanishi

    Clinical psychiatry　61　(5)　517-523　2019/05

    Publisher: 医学書院

    ISSN： 0488-1281

  13. 地域の自殺対策から見えてきた自殺統計の課題―川崎市の取組をもとに―

    竹島正, 植木美津枝, 鈴木剛, 山内貴史, 井原一成, 中西三春, 贄川信幸, 高井美智子, 岡野敏明, 坂元昇, 張賢徳

    39　(1)　21-24　2019/03

  14. The actual condition of factors of professional caregivers' turnover in elderly care facilities : a qualitative study using the "Healthy Work Organization (HWO)" conceptual model

    TOMINAGA Maki, NAKANISHI Miharu

    The Journal of Science of Labour　95　(4)　117-126　2019

    Publisher: The Ohara Memorial Institute for Science of Labour

    DOI： 10.11355/isljsl.95.117 　

    ISSN： 0022-443X

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    <p>Based on the "Healthy Work Organization (HWO)" conceptual model, we conducted a qualitative study using a semi-structured interview subjecting 14 unit-leaders of professional caregivers in elderly care facilities to reveal the actual condition of factors involved in their turnover. Three categories, that consist of 23 sub-categories identified from 62 codes, emerged regarding factors of resignation among professional care givers. One of the categories, namely "specificity of care services," was fit to the "work and workplace characteristics" within the HWO conceptual model, and the remaining two categories, namely "not established labor and personnel management system" and "undeveloped organizational policy and structure," were fit to the "organizational characteristics" in the model. The findings suggested that countermeasures toward the turnover of professional caregivers are required for both the work and the workplace characteristics and the organizational characteristics influencing the former characteristics.</p>

  15. Dementia Care in General Acute Care Hospitals:A Nationwide Cross-sectional Survey in Japan Invited

    Nakanishi Miharu

    Journal of Japan Academy of Gerontological Nursing　23　(2)　44-48　2019

    Publisher: Japan Academy of Gerontological Nursing

    DOI： 10.20696/jagn.23.2_44 　

    ISSN： 1346-9665

  16. Suicide prevention, national policy, and local administration : challenges in policy evaluation due to governmental framework and system Invited

    Miharu Nakanishi

    Japanese journal of health economics & policy　31　(1)　3-14　2019

    Publisher: 医療経済学会 ; 1994-

    ISSN： 1340-895X

  17. 高齢者虐待防止と権利擁護 : 法に基づく対応状況調査結果(厚労省)を踏まえて

    中西 三春

    権利擁護・虐待防止　(0)　55-60　2018

    Publisher: 全国社会福祉協議会

  18. Prevention of elder mistreatment and advocacy service: Results of national administrative data by the Ministry of Health, Labour and Welfare Invited

    Miharu Nakanishi

    Advocacy and prevention of mistreatment　47-52　2018

    Publisher: 全国社会福祉協議会

  19. How have municipal governments implemented suicide prevention activities under the 'Fund for the Urgent Enhancement of Local Suicide Prevention' allocated by the Cabinet Office? Invited

    Miharu Nakanishi

    Suicide prevention and crisis invervention　36　(3)　44-50　2016/09

    Publisher: 日本自殺予防学会

    ISSN： 1883-6046

  20. Issues and implications for current dementia care : Examination based on the view of global "palliative care for dementia" wave Invited

    Miharu Nakanishi, Atsushi Nishida

    Psychiatry　29　(1)　38-43　2016/07

    Publisher: 科学評論社

    ISSN： 1347-4790

  21. 大都市圏の高齢単身世帯における要介護高齢者の施設等移行に関する要因

    中島 民恵子, 中西 三春, 沢村 香苗

    厚生の指標　62　(12)　15-21　2015/10

    Publisher: 厚生労働統計協会

    ISSN： 0452-6104

  22. National Dementia Strategy in Australia Invited

    Miharu Nakanishi, Taeko Nakashima

    The Review of Comparative Social Security Research　190　(190)　24-38　2015

    Publisher: 国立社会保障・人口問題研究所

    ISSN： 1344-3062

  23. 介護保険施設における認知症の人の看取りを行うための教育ケアプログラムの開発

    中西 三春, 奥村 泰之, 宮本 有紀

    日本認知症ケア学会誌　13　(1)　331-331　2014/04

    Publisher: (一社)日本認知症ケア学会

    ISSN： 1882-0255

  24. 研究部レポート 地域包括ケアに関する指標の検討 : 地域包括支援ネットワークの構成と機能の把握と地域包括ケアの課題に関する調査

    中西 三春

    Monthly IHEP　(222)　51-55　2013/08

    Publisher: 医療経済研究機構

  25. 医療資源の配置とナーシングホームへの入所の地域差に関する国際比較

    中西 三春

    Monthly IHEP　(210)　12-15　2012/07

    Publisher: 医療経済研究機構

  26. 市区町村における高齢者虐待防止の標準化のための体制整備状況の関連要因および支援のあり方の検討

    中西 三春

    医療経済研究機構レター　(201)　14-17　2011/09

    Publisher: 医療経済研究機構

  27. 市区町村における高齢者虐待防止のための体制整備への取組み状況に関連する要因

    中西 三春

    医療経済研究機構レター　(188)　26-29　2010/07

    Publisher: 医療経済研究機構

  28. Situation and issues on elder abuse in domestic settings in Japan Invited

    Miharu Nakanishi, Taeko Nakashima

    Journal of Japanese Society for Dementia Care　9　(3)　451-456　2010

    Publisher: 日本認知症ケア学会

    ISSN： 1882-0255

  29. 市区町村における高齢者虐待防止のための体制整備への取組み状況

    中西 三春

    医療経済研究機構レター　(174)　19-23　2009/04

    Publisher: 医療経済研究機構

  30. 介護・福祉現場における看取りの現状と課題--「在宅高齢者等のターミナル期における介護、看護のあり方に関する研究」の調査結果より (特集 看取りと福祉) Invited

    中西 三春

    月刊福祉　91　(3)　26-29　2008/03

    Publisher: 全国社会福祉協議会

    ISSN： 1341-6669

  31. 「精神科入院患者の退院支援と地域生活支援のあり方に関する研究」「地域精神保健医療についての海外調査」

    瀬戸屋雄太郎, 河野稔明, 姜恩和, 沢村香苗, 中西三春, 吉田光爾

    精神科入院患者の退院支援と地域生活支援のあり方に関する研究 平成19年度 総括・分担研究報告書　43-90　2008

  32. 認知症を有する高齢者へのターミナルケア:認知症グループホームにおける看取りと家族の関わり

    中西 三春

    医療経済研究機構レター　(159)　19-21　2007/11

    Publisher: 医療経済研究機構

  33. 一般病院における退院準備・在宅ケア移行支援システムの現状

    永田 智子, 佐藤 美穂子, 宇都宮 宏子, 中西 三春, 新野 由子, 服部 啓子, 戸村 ひかり, 鈴木 樹美

    病院管理　44　87-87　2007/09/01

    ISSN： 0386-9571

  34. 高齢者虐待について理解するための6冊

    中西 三春

    こころの健康　22　(1)　83-86　2007

    Publisher: 日本精神衛生学会

    DOI： 10.11383/kokoronokenkou1986.22.83 　

    ISSN： 0912-6945

  35. 研究紹介 精神及び知的障害者の介護ニーズの評価手法の開発に関する研究

    小高 真美, 安西 信雄, 堀口 寿広, 瀬戸屋 雄太郎, 槇野 葉月, 中西 三春, 西村 秋生, 山内 慶太, 三村 将, 佐藤 久夫, 天笠 崇, 湯汲 英史, 荒田 寛, 宮本 有紀

    国立精神・神経センター精神保健研究所年報　(19)　96-97　2006/10

    Publisher: (国研)国立精神・神経医療研究センター精神保健研究所

    ISSN： 0915-0056

  36. 精神科急性期入院医療のクリニカルパスに関する研究(その1) 大うつ病性障害入院医療パス

    小山 明日香, 中西 三春, 原田 誠一, 計見 一雄, 澤 温, 宮岡 等, 前田 久雄, 筧 淳夫, 伊藤 弘人, 樋口 輝彦

    精神神経学雑誌　106　(11)　1517-1517　2004/11

    Publisher: (公社)日本精神神経学会

    ISSN： 0033-2658

  37. 精神科急性期入院医療のクリニカルパスに関する研究(その2) 統合失調症急性期入院医療パス・興奮状態による隔離室使用パス

    中西 三春, 小山 明日香, 原田 誠一, 計見 一雄, 澤 温, 宮岡 等, 前田 久雄, 筧 淳夫, 伊藤 弘人, 樋口 輝彦

    精神神経学雑誌　106　(11)　1517-1518　2004/11

    Publisher: (公社)日本精神神経学会

    ISSN： 0033-2658

  38. 精神科急性期入院医療における抗精神病薬処方の多施設間比較

    小山 明日香, 中西 三春, 沢村 香苗, 伊藤 弘人, 樋口 輝彦

    病院管理　41　(Suppl.)　252-252　2004/08

    Publisher: (一社)日本医療・病院管理学会

    ISSN： 0386-9571

  39. スクールカウンセリング・システム構築のための包括的ニーズ調査（その2）―保護者用包括的ニーズ評価尺度 CAN-SCS（P-version）の信頼性と妥当性

    黒沢幸子, 森俊夫, 有本和晃, 中西三春

    目白大学人間社会学部紀要　(2)　27-41　2002/02

    Publisher: 目白大学人間社会学部

    ISSN： 1346-2202

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Books and Other Publications 6

  1. よくわかる自殺対策－多分野連携と現場力で「いのち」を守る

    中西 三春

    ぎょうせい　2015/04

    ISBN: 9784324099360

  2. 認知症地域ケアガイドブック 早期発見から看取りまで

    中西 三春

    ワールドプランニング　2012/05

    ISBN: 9784863510494

  3. これからの子ども家庭ソーシャルワーカー－スペシャリスト養成の実践

    中西三春

    ミネルヴァ書房　2010/03

    ISBN: 9784623055951

  4. チームで行う退院支援 入院時から在宅までの医療・ケア連携ガイド

    中西三春

    中央法規出版　2008/08

    ISBN: 4805848332

  5. リエゾン精神看護1. 成長発達と起こりうる問題8. 不安障害. パーフェクト臨床実習ガイド, 精神看護実習ガイド.

    照林社　2007

    ISBN: 4796521429

  6. リエゾン精神看護 1. 成長発達と起こりうる問題10. 強迫. パーフェクト臨床実習ガイド, 精神看護実習ガイド.

    照林社　2007

    ISBN: 4796521429

Show all Show first 5

Presentations 18

  1. RECIPROCALITY OF COGNITIVE IMPAIRMENT, PAIN, AND DEPRESSION: MODELING WITHIN-PERSON EFFECTS International-presentation International-coauthorship

    Miharu Nakanishi, Marieke Perry, Rachele Bejjani, Satoshi Yamaguchi, Satoshi Usami, Jenny van der Steen

    The Gerontological Society of America (GSA) Annual Scientific Meeting 2024　2024/11/16

  2. HOW INTERNATIONAL EXPERTS DEFINE ADVANCE CARE PLANNING: A CONTENT ANALYSIS International-presentation International-coauthorship

    Jenny van der Steen, Emma de Wit, Mandy Visser, Miharu Nakanishi, Lieve Van den Block, Ida Korfage, Jürgen In Der Schmitten, Rebecca Sudore

    The Gerontological Society of America(GSA) Annual Scientific Meeting 2024　2024/11/16

  3. Holistic dementia care continuum from the point of diagnosis to the end of life: Progress and challenges in translating national dementia policies into daily practice in Japan International-presentation Invited

    Miharu Nakanishi, Asao Ogawa, Atsushi Nishida

    Alzheimer's Association International Conference 2024　2024/07/29

  4. Recommendations for Policy and Research for Advance Care Planning in Dementia: International Consensus Recommendations from a Delphi Panel of European Association for Palliative Care Taskforce International-presentation International-coauthorship

    Miharu Nakanishi, Sandra Martins Pereira, Lieve Van den Block, Deborah Parker, Karen Harrison-Dening, Paola Di Giulio, Jürgen in der Schmitten, Philip Larkin, Ninoslav Mimica, Rebecca L. Sudore, Iva Holmerová, Ida Korfage, Jenny T. van der Steen

    36th Global Conference of Alzheimer's Disease International　2024/04/24

  5. Characteristics of home-dwelling persons with dementia and families who have initiated advance care planning during the COVID-19 pandemic in Japan International-presentation

    Miharu Nakanishi

    ACP-i Conference 2023　2023/05/24

  6. A definitional framework of advance care planning in dementia achieved a consensus in a 33-country delphi study International-presentation International-coauthorship

    Jenny van der Steen, Miharu Nakanishi, Lieve Van den Block, Ida J Korfage

    ACP-i Conference 2023　2023/05/24

  7. 外国人介護職の雇用に関する質的研究 高齢者介護施設における定着にむけた取り組み

    富永 真己, 田中 真佐恵, 杉山 智子, 矢吹 知之, 中西 三春

    日本衛生学雑誌　2022/03

  8. 高齢者介護施設における外国人介護職の採用後の実態 利点と課題

    富永 真己, 杉山 智子, 田中 真佐恵, 矢吹 知之, 中西 三春

    日本公衆衛生学会総会抄録集　2021/11

  9. 日本の高齢者介護施設で従事する外国人介護職の就業に関する実態と課題

    杉山 智子, 富永 真己, 田中 真佐恵, 矢吹 知之, 中西 三春

    日本国際看護学会誌　2021/09

  10. 介護職のディーセント・ワークの実態 性別・年代別の比較分析による研究

    富永 真己, 中西 三春, 田中 真佐恵, 矢吹 知之

    日本衛生学雑誌　2021/03

  11. 日本の介護職における外国人介護職の受入れへの期待と不安に関する研究

    富永 真己, 中西 三春, 矢吹 知之, 田中 真佐恵

    日本公衆衛生学会総会抄録集　2020/10

  12. 認知症のGood Deathとは何か? 遺族・医師・看護師・介護職の認識に関するWeb調査

    野中 瑞穂, 青山 真帆, 中西 三春, 山川 みやえ, 深堀 浩樹, 佐藤 一樹, 高橋 在也, 長江 弘子, 森田 達也, 坂井 志麻, 宮下 光令

    Palliative Care Research　2020/08

  13. 認知症の有無ががん患者の看取りの質に与える影響

    廣岡 佳代, 中西 三春, 深堀 浩樹, 西田 淳志

    Palliative Care Research　2019/06

  14. 認知症患者におけるGood Deathの在り方に関する認知症患者、家族、医師、看護師、介護職に対するインタビュー調査の内容分析

    渡会 紘子, 高橋 在也, 山川 みやえ, 青山 真帆, 五十嵐 尚子, 坂井 志麻, 深堀 浩樹, 中西 三春, 佐藤 一樹, 長江 弘子, 宮下 光令

    Palliative Care Research　2019/06

  15. 認知症患者における望ましい人生の最終段階のあり方についてのインタビュー調査

    田村 菜津子, 青山 真帆, 五十嵐 尚子, 山川 みやえ, 坂井 志麻, 深堀 浩樹, 中西 三春, 佐藤 一樹, 長江 弘子, 高橋 在也, 宮下 光令

    Palliative Care Research　2018/06

  16. 介護保険施設における認知症の人の看取りを行うための教育ケアプログラムの開発

    中西 三春, 奥村 泰之, 宮本 有紀

    日本認知症ケア学会誌　2014/04

  17. 一般病院における退院準備・在宅ケア移行支援システムの現状

    永田 智子, 佐藤 美穂子, 宇都宮 宏子, 中西 三春, 新野 由子, 服部 啓子, 戸村 ひかり, 鈴木 樹美

    病院管理　2007/09/01

  18. 精神科急性期入院医療における抗精神病薬処方の多施設間比較

    小山 明日香, 中西 三春, 沢村 香苗, 伊藤 弘人, 樋口 輝彦

    病院管理　2004/08

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Research Projects 21

  1. Psychosocial intervention programmes in dementia Competitive

    Miharu Hada-Nakanishi, Jenny van der Steen, Helma Verstraeten, Katarina Nägga

    Offer Organization: The Lorentz Center

    2025/08 - 2025/08

  2. International research on advance care planning and palliative care approach for persons with dementia and family caregivers

    Miharu Nakanishi

    Offer Organization: Japan Society for the Promotion of Science

    System: Fund for the Promotion of Joint International Research (Fostering Joint International Research (A))

    Category: Fund for the Promotion of Joint International Research (Fostering Joint International Research (A))

    Institution: Tohoku University

    2023/04 - 2025/03

  3. Development of delirium support program to reduce the medical burden in acute hospital Competitive

    Asao Ogawa, Nobuyoshi Takeshita, Miharu Nakanishi, Atsushi Mizuno, Yasuyuki Okumura

    Offer Organization: Japan Agency for Medical Research and Development

    2022/04 - 2025/03

  4. System development to promote implementation of advance care planning for people with dementia to live with hope

    Miharu Nakanishi, Yuki Miyamoto, Syudo Yamasaki, Taeko Nakashima

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (B)

    Category: Grant-in-Aid for Scientific Research (B)

    Institution: Tokyo Metropolitan Institute of Medical Science

    2021/04 - 2025/03

  5. Collaboration with University College London on young carers’ mental health in the COVID-19 pandemic Competitive

    Miharu Nakanishi, Marcus Richards, Atsushi Nishida, Syudo Yamasaki

    Offer Organization: The Great Britain SASAKAWA Foundation

    2021/12 - 2022/11

  6. Development and programme implementation of support system for dementia care adopting artificial intelligence to elevate prevention, early detection and management of neuropsychiatric symptoms Competitive

    Asao Ogawa, Kei Hirai, Yasuyuki Okumura, Hitoshi Tanimukai, Sho Tanimukai, Miharu Nakanishi, Shinichiro Inoue, Keiichi Uemura, Hiroki Fukahorhi, Masanori Enokido, Nobuyoshi Takeshita

    Offer Organization: Ministry of Health, Labour and Welfare

    2019/04 - 2022/03

  7. Establishment of platform for evidence in mental health care services and after-discharge outcome measures for long-term inpatients in psychiatric hospitals

    Sayaka Sato, Miharu Nakanishi, Sosei Yamaguchi, Chiyo Fujii

    Offer Organization: Ministry of Health, Labour and Welfare

    2019/04 - 2022/03

  8. Dissemination and implementation of advance care planning that helps people maintain hope in the lives of those with dementia and families Competitive

    Taeko Nakashima

    Offer Organization: Pfizer Health Research Foundation

    2020/12 - 2021/11

  9. Cost-effectiveness of interdisciplinary psychosocial approach for neuropsychiatric symptoms of dementia using IoT based technology Competitive

    Miharu Nakanishi

    Offer Organization: Policy-Based Medical Services Foundtion

    2020/05 - 2021/05

  10. Good Death in people with dementia

    Miyashita Mitsunori

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (B)

    Institution: Tohoku University

    2016/07/19 - 2020/03/31

    More details Close

    The aim of this study was to determine what the Good Death is in people with dementia and whether it is being achieved. As a result of the literature review, interview and questionnaire surveys, the components of Good Death in patients with dementia were categorized into four factors: “comfort, security and safety,” “relationships,” “independence,” and “the ability to maintain their individuality and lack of constraint.” A survey of bereaved families found that, overall, Good Death was more frequently achieved in people with dementia.

  11. Psychosocial approaches in health and social care for persons living with dementia

    Miharu Nakanishi

    Offer Organization: The Institute of Seizon and Life Sciences

    System: Research Grant

    2017/04 - 2020/03

  12. Effect of organizational characteristic of facilities in regional comprehensive health care system on the Organizational Health: a study using a conceptual model of the Healthy Work Organization

    Tominaga Maki, NAKANISHI miharu, KAWAI takako

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (B)

    2016/04/01 - 2019/03/31

    More details Close

    We conducted qualitative and quantitative research using Healthy Work Organization model to examine the influence of Organizational Characteristics (OC) as factors involved in Organizational Health (e.g., intentions to leave) in facilities in regional comprehensive healthcare system. For quantitative research, nurses and professional care workers（N = 1396) of 26 facilities were invited to participate (response rate was 68%). We addressed original 20-item scale of the social capital and ethical climate at the workplace (SEW) as OC. The findings revealed that organizational characteristics influenced on Organizational Health (e.g., work-related accidents and injuries, their intentions to leave, happiness at workplace). Additionally, the findings of qualitative research revealed three categories for factors of turnover and two categories for factors of retention, respectively. Findings suggested the countermeasures for OC.

  13. Reviewing process of guidelines for severe psychiatric outpatient care in Japan

    Michika TANOUE

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (B)

    2015/04/01 - 2019/03/31

    More details Close

    In this study, we aimed to formulate guidelines for severe psychiatric outpatients who live in their community and with their families. We created a draft of the guideline by examining the contents of pre-existing guidelines and evaluation methods. We selected eight areas, 20 categories, and 97 items to evaluate for "The Care" content. The delphi method was used to evaluate the guidelines. The assessment was conducted as an anonymous survey on a web, measuring the importance, difficulty, and frequency of the care. 50 professionals participated in our study. The primary results revealed that 96 items out of 97 of the importance section scored 8.0 points or over, with interquartile range (IQR) percentage (percentage of respondents who fall within IQR range) of 76.0 ～ 92.0%. The importance of the formulated care items were generally highly valued. There were minimal scatters of the answers. Further assessment is necessary to increase the validity of the study.

  14. Development of a support program for people with dementia in acute hospital settings (PENTA program) as a multidisciplinary intervention for dementia treatment and care Competitive

    Asao Ogawa, Yasuyuki Okumura, Shinichiro Inoue, Keiichi Uemura, Kei Hirai, Hitoshi Tanimukai, Shinsuke Kondo, Mariko Kaneko, Miharu Nakanishi

    Offer Organization: Japan Agency for Medical Research and Development

    System: Research and Development Grants for Dementia

    2016/04 - 2019/03

  15. Quality of life of people with dementia in long-term care settings Competitive

    Miharu Nakanishi

    Offer Organization: Japan Society for Promotion Science, Grants-in-Aid for Scientific Research

    System: Grant-in-Aid for Young Scientists (B)

    2015/04 - 2019/03

  16. A study on recognition of nursing professionals on decision-making sharing (SDM) for mentally disabled persons

    NIIMURA Junko

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (C)

    Institution: Tokyo Metropolitan Institute of Medical Science

    2015/04/01 - 2018/03/31

    More details Close

    We formed a core research team consisting of mental health professionals and users.On this team, we continuously discussed what kind of structure and care factors were necessary to implement Shared Decision Making (SDM) with users in the psychiatric emergency unit. Through these discussions and inspections of overseas service providers that implemented patient-centered care and review of literature, we revealed that Trauma Informed Care (TIC), which was implemented mainly in the USA since the 1990s was effective. We conducted training for psychiatric clinical staff and investigated changes in knowledge and attitudes of participants both pre and post the training using self-reported questionnaires.

  17. Restraint and Seclusion prevention: development of a dialogue-oriented approach based on peer support relationships

    Miyamoto Yuki, NAKANISHI Miharu, KUNO Eri, POCKLINGTON Stephen, MEAD Shery

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Challenging Exploratory Research

    Institution: The University of Tokyo

    2014/04/01 - 2017/03/31

    More details Close

    Restrictions in patients' freedom of movement, such as physical restraint and seclusion, have negative impacts on patients and healthcare providers. Our goal is to create an environment in which service providers are aware of their own feelings and have dialogues with patients/users. This type of environment would develop the service setting into a place where restraints are not required. Therefore, we developed a dialogue-oriented training workshop that is based on peer support relationships by reference to Intentional Peer Support. The workshop participants reported that they noticed the importance of being aware of their feelings. We were unable to reach the phase of examining the effect on decreasing physical restraint and seclusion.

  18. Views on palliative care in dementia among direct care workers of residential facilities in Japan Competitive

    Miharu Nakanishi, Yasuyuki Okumura, Yuki Miyamoto

    Offer Organization: Pfizer Health Research Foundation in Japan

    2013/12 - 2014/11

  19. Research on a system to promote appropriate countermeasures against elderly abuse of the community general support centers based on the group interviews

    SAKATA Nobuko, KIMURA Nobuo, TANAKA Atuko, KASAHARA Ayako, NAKANISI Miharu, HONNDA Eri, MAEHARA Tiemi, MAZIMA Tizuko, WATANABE Takumi

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (C)

    Institution: Toyo University

    2011 - 2013

    More details Close

    This research is based on the focus group interviews by occupation targeting certified social workers, public health nurses, chief care managers, and administrative officers of the community general support centers in two areas. The survey found that there exist two types of action assignments: those different from each other depending on the areas and community general support centers and those in common with each other. This research makes proposals (draft)for promoting a system to provide appropriate countermeasures against elderly abuse while classifying these common action assignments into the following five categories; the internal organization of administration, the internal organization of a community general support center,organization for cooperation and coordination between administration and a community general support center, regional organization surrounding the community general support center, and the national-level policies.

  20. International comparative study on dementia care Competitive

    Taeko Nakashima, Miharu Nakanishi, Kumiko Nagata

    Offer Organization: Ministry of Health, Labour and Welfare

    2010/04 - 2012/03

  21. Discharge planning and community-based care for long-term inpatients in psychiatric hospitals Competitive

    Kanae Sawamura, Nobuo Anzai, Yutaro Setoya, Miharu Nakanishi

    Offer Organization: Ministry of Health, Labour and Welfare

    System: Grant for Research on Policy Planning and Evaluation

    2007/04 - 2009/03

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Teaching Experience 6

  1. 高齢者の心理臨床　帝京大学文学部心理学科

  2. 保健と医療の社会学　淑徳大学総合福祉学部人間社会学科

  3. 保健医療福祉行政学　東京医療保健大学医療保健学部看護学科

  4. 国際医療福祉論（スウェーデン）　国際医療福祉大学

  5. 精神の健康　千葉県立野田看護専門学校

  6. 問題を抱える子どもへの支援Ⅲ（非行、不登校）　日本社会事業大学社会福祉学部

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Works 2

  1. "Comfort Care at the End of Life for Persons with Alzheimer’s Disease or Other Degenerative Diseases of the Brain" Japanese translation

    Miharu Nakanishi, Taeko Nakashima

    2015/07 -

    Type: Other

  2. Translation of the EAPC white paper on dementia

    Miharu Nakanishi

    2015/06 -

    Type: Other

Media Coverage 21

  1. 閉経が早いと認知機能低下が早まる可能性 女性ホルモンが鍵か

    産経新聞社

    2025/05/11

    Type: Internet

  2. Addressing Dementia through a Human-Centered Approach in Tokyo and Beyond

    Tokyo Metropolitan Government　Tokyo Updates　https://www.tokyoupdates.metro.tokyo.lg.jp/en/post-1408/

    2024/12/18

    Type: Internet

  3. 青梅市の認知症グループホーム「福わ家」 少人数の共同生活で可能な限り自立した生活 「日本版BPSDプログラム」を導入し一人一人のニーズにあったケア

    テレビ朝日　東京サイト

    2024/09/20

    Type: TV or radio program

  4. 令和６年度東京都認知症シンポジウム

    東京都高齢者施策推進部在宅支援課チャンネル

    2024/09/17

    Type: Internet

  5. 【高齢化で増える認知症】“特徴的な行動”背景には不安が…数値化し分析・症状改善へ

    日本テレビ　news every.

    2024/09/14

    Type: TV or radio program

  6. #010 誰もがよりよく生きられる社会をつくるには？認知症とアドバンス・ケア・プランニング

    東北大学総務企画部広報室　Podcast番組「東北大学の研究第一」

    2024/05/31

    Type: Internet

  7. Second publication of the EAPC taskforce Advance Care Planning in dementia Myself

    Lifecourse Epidemiology and Geroscience (LEGend), Leiden University Medical Center

    2024/04/16

    Type: Other

  8. [Decision making on healthcare] people with dementia <3> how to decide the approach for surgery and treatment

    The Yomiuri Shinbun

    2020/12/23

    Type: Newspaper, magazine

  9. Den sidste udvej

    Weekendavisen

    2020/12/18

    Type: Internet

  10. [Decision making on healthcare] people with dementia <2> my way of life with families

    The Yomiuri Shinbun

    2020/11/24

    Type: Newspaper, magazine

  11. Monthly care cost per individual with Alzheimer's disease is 230 thousands yen

    Mainichi newspaper　Premier Health, Health Day News

    2020/02/29

    Type: Newspaper, magazine

  12. Women with higher psychological well-being had a lower risk of cognitive decline

    Mainichi Newspaper

    2020/01/23

    Type: Newspaper, magazine

  13. Nearly half of dementia patients in Japan put in restraints: study

    Mainichi Japan

    2018/11/19

    Type: Newspaper, magazine

  14. One-third of inpatients with dementia underwent physical restraint in acute hospitals

    Yomiuri Shimbun (newspaper)

    2018/10/21

    Type: Newspaper, magazine

  15. 縛らない医療，ひらかれた看護 尊厳あるケアのために

    医学書院　週刊医学界新聞

    2018/05/28

    Type: Newspaper, magazine

  16. Less valuable medicine: the effect of psychotoropics is suboptimal on hallucination and delusion among people with dementia

    The Mainichi newspaper

    2018/04/29

    Type: Newspaper, magazine

  17. Visualized challenging behaviour of dementia in the programme developed by Tokyo Metropolitan Institute of Medical Science

    Mainichi

    2017/09/24

    Type: Newspaper, magazine

  18. Is the total number of people with dementia rising across the globe?

    Mainichi newspapers　Q&A

    2017/05/14

    Type: Newspaper, magazine

  19. The Aging Readiness & Competitiveness Report - Japan

    Foreign Policy Analytics

    2017/05

    Type: Newspaper, magazine

  20. Coping with senility in Japan. Grey zone: As cases of dementia rise, Japan gropes for new ways to deal with them.

    The Economist

    2016/04/09

    Type: Newspaper, magazine

  21. More research needed to prevent elder abuse

    Reuters

    2016/01/22

    Type: Newspaper, magazine

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