Publishing type：Research paper (scientific journal)   Publisher：BMJ  

Objectives

The primary objective of this study was to develop the Japanese version of the Patient Centred Assessment Method (PCAM) and its user guide. The secondary objective was to examine the validity and reliability in the primary care setting.

Design

Cross-sectional study.

Setting

Three family physician teaching clinics located in urban residential areas in Tokyo, Japan.

Participants

Patients who were aged 20 years or older, and who had an appointment with physicians at the three participating clinics.

Main outcome measures

Patient complexity measured by PCAM and complexity/burden level measured by a Visual Analogue Scale (VAS).

Results

Although confirmatory factor analysis using a model described in a previous study revealed that the indices did not meet the criteria for good fit, exploratory factor analysis revealed a new three-factor structure of ‘Personal well-being,’ ‘Social interaction’ and ‘Needs for care/service.’ Cronbach’s alpha of PCAM was 0.86. Spearman’s rank correlation coefficients between PCAM scores and VAS scores were 0.51 for complexity (p<0.001) and 0.41 for burden (p<0.001). There were 42 patients (14.3% of total patients) with PCAM scores greater than its mean of 16.5 but with complexity VAS scores less than its mean of 20.8.

Conclusions

The Japanese version of PCAM and its user guide were developed through Japanese translation and cultural adaptation by cognitive debriefing. PCAM is a valid and reliable tool to assess patient complexity in the primary care settings in Japan. Additionally, although the correlation between total PCAM scores and complexity/burden as assessed by VAS was moderate, PCAM can more precisely identify patient complexity than skilled physician’s intuition.

DOI： 10.1136/bmjopen-2020-037282

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Publishing type：Research paper (scientific journal)   Publisher：BMJ  

Objectives

An ageing society includes high patient complexity. Various biopsychosocial problems result in a high burden for health-related professionals. The direct relationship between the burden and patient complexity, however, has not been reported. We aimed to examine correlations between the burden for the attending physicians and nurses, and Patient Centred Assessment Method (PCAM) scores of patient complexity.

Design

Prospective cohort study.

Setting

A regional secondary care hospital in Japan.

Participants

We included all inpatients admitted to our acute care unit between 1 July 2014 and 30 September 2014. Exclusion criteria were age <20 years, refusal to participate in the study and length of stay fixed at the time of admission.

Main predictor

PCAM total score in the initial phase of hospital admission.

Main outcome

The burden for each profession (measured on a Visual Analogue Scale).

Results

In total, 201 inpatients participated [female/male=98/103, mean (SD) age of 77.4±11.9 years]. Spearman’s rank correlation coefficients between the burden and the PCAM score ranged from 0.23 to 0.32. All p values were <0.05. Multivariate analysis was conducted using multilevel mixed-effects linear regression to determine the association between the burden and the PCAM score in two models. Model 1 used the total PCAM score as the predictive variable. Model 2 used the PCAM factors, patient-oriented complexity and medicine-oriented complexity, as predictive variables. In Model 2, with the burden of physicians, medicine-oriented complexity was statistically significant, whereas with the burden of nurses, both age and patient-oriented complexity were statistically significant.

Conclusions

PCAM scores correlated with the burden for physicians and nurses. Individual PCAM factors affected the burden for each profession differently.

DOI： 10.1136/bmjopen-2018-025176

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.nut.2017.11.009

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Authorship：Lead author   Publishing type：Research paper (scientific journal)  

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Authorship：Lead author  

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Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Japan Society of Engineering Geology  

DOI： 10.4263/jorthoptic.043f101

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Society of Engineering Geology  

DOI： 10.4263/jorthoptic.042f014

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J01962&link_issn=&doc_id=20140110190020&doc_link_id=%2Fdg7ortho%2F2013%2F004200%2F020%2F0147-0153%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg7ortho%2F2013%2F004200%2F020%2F0147-0153%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Japan Society of Engineering Geology  

DOI： 10.4263/jorthoptic.040f110

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