How to Study for Your Development - Japanese (Japanese Edition)

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This tool could be used for health service research in primary care. In recent years, quality of medical care has attracted a lot of attention in policymaking and quality improvement 1.

Each country promotes actions for quality assessment to achieve accountability for medical care. Primary care plays an important role in improving quality of the whole health care system. Evidence indicates that primary care contributes to better health outcomes, equity and costs 2. Therefore, measuring and improving the quality of primary care are significant in the construction of strong health care systems 3. Although this free access may mask any deficit in the Japanese primary care system, inefficiencies in the system are now being recognized in view of the aging Japanese population with multiple morbidities, increasing costs need for specialist care and health disparities, particularly among the elderly adults 6.

Primary care in Japan is typically delivered by specialists, who leave hospital practice, with no further compulsory education in the community. The inadequacy of primary care training for Japanese physicians has been raised as a quality issue; therefore, the Japanese Medical Specialty Board is now developing a system of accrediting primary care specialists as a new discipline, which will commence in For high-quality health care, patient centredness is defined as providing care that is respectful of and responsive to individual patient preferences, needs and values 7.

Among them, patient experience surveys could be considered the most effective measure of patient centredness. Patient experience surveys enable objective quality assessment data to be obtained by inquiring about events in the process of care. Patient centredness is a crucial concept for quality assessment, especially in the primary care setting 8. There are four PCAT versions: The consumer—client survey both adult and child surveys is designed to collect information from consumers or family caretakers regarding their experience using health care resources.

According to the results of previous qualitative studies undertaken with residents, important primary care principles in Japan were accessibility, comprehensiveness, coordination, continuity, community orientation and family orientation 20— The PCAT, covering all of these principles, is considered to be a reasonable instrument for assessing quality of primary care in Japan.

In this manner, systematic qualitative improvement of primary care has just begun in Japan, and effective approaches for quality assessment are still inadequate. Tools for assessing quality of primary care from patient experience have never previously existed. A cross-sectional study was conducted to examine the validity and reliability of the JPCAT using a mail survey.

Associated Data

We assessed the validity content, construct and criterion related and the reliability of internal consistency. The construct validity consists of factorial validity, item-convergent validity and item-discriminant validity. Potential participants for the study were randomly selected from residents aged 40—75 years old in the sampling site using a basic resident register. Socio-economic factors were employed to ensure that our selection of the sampling site represented the Japanese national standard. The authors selected Kita City, located in northern Tokyo, where the proportion of the older population and households receiving welfare payments were equivalent to the Japanese national level.

According to previous studies, a minimum sample size of having usual source of care USC is necessary to perform satisfactory factor analysis We sent the questionnaire to randomly selected residents from the register.

The data were collected between September and October Four weeks after the initial mailing, a reminder was sent out to increase the response rate. Regardless if the participants responded to the survey, they were given small gifts worth JPY.

STUDY in JAPAN

First, the forward translation English to Japanese was performed by a bilingual resident of Japan, who had experience and qualifications in translating. Second, the research team performed quality review of each translated item to evaluate the validity and clarity of the content. The research team included a qualified primary care physician, a primary care researcher and a health service researcher.

Among 96 items, 15 items in the comprehensiveness and cultural competency domain were identified as being inapplicable in their original form as applied to the general Japanese health care system and were excluded. Third, an expert panel comprising 10 primary care physicians, 4 primary care researchers and 2 health service researchers was formed to identify items in the comprehensiveness domain, which matched the Japanese health care system because comprehensiveness of primary care varies from country to country according to its health care system.

We used a Delphi method 25 to evaluate the adequacy of 31 items in the original PCAT and the 19 new items added by the participants. Two rounds of voting, using a nine-point appropriateness scale, were conducted As a result, the five items that were deemed inappropriate for comprehensiveness of primary care in Japan were excluded, and a item pilot questionnaire, covering the same domains as the original version of PCAT, was produced.

Next, we conducted a qualitative cognitive testing for item review. We asked a group of Japanese patients who belonged to a non-profit organization to review the survey items.

Ministry of Education, Culture, Sports, Science and Technology

This non-profit organization was a patient advocacy group, which promotes better communication between physicians and patients including elderly and people with low health literacy. A focus group discussion with 10 participants was held to evaluate wording, comprehensibility and response format. We used the responses obtained from this focus group to modify the items and response format. To make the results easier to understand, we converted Likert scales to scores ranging from 0 to All Likert scale scores were reduced by a factor of 1 and multiplied by The score for each of the six domains was computed as the mean value for all converted scale scores in that domain.

Introduction

In the coordination domain, asking about the experiences of referral to a specialist, if respondents had never seen a specialist, 50 points the middle number of the possible scores were given. We calculated a total score for this Japanese version of PCAT using the mean value of all the domain scores that would fall in the range of 0— points, with higher scores indicating better performance.

We included in our survey socio-demographic data on age, sex, employment, years of education and household income, in addition to overall user satisfaction of their USC for assessment of criterion-related validity. First, we excluded the items that demonstrated large floor and ceiling effects using descriptive statistics. Second, we used factor analysis to explore the structure of the JPCAT items and examine its construct validity. The correct number of common factors was obtained based on the initial exploratory factor analysis. The results from this initial factor analysis were further tested using principal factor analysis and varimax rotation.

For a scale to be considered sufficiently reliable, an alpha value of 0. All the retained items should exceed the minimum acceptable item-total correlation of 0. Fourth, the Likert scaling assumptions were tested by assessment of item-convergent validity and item-discriminant validity The item-convergent validity was tested by item-scale correlations.

We defined an item-scale correlation of 0. The item-discriminant validity was tested using scaling success rate correlation of each item with other items within the same scale being greater than with items from different scales. Next, overall user satisfaction of respondents as primary care users was used to examine criterion-related validity. Finally, descriptive statistics were performed for the revised primary care scales, including the mean, standard deviation, range, skewness and kurtosis. We used SPSS version 22 for statistical analyses.

A total of The respondents were significantly older compared with the non-respondents mean ages: In the responses, a total of effective samples that had USC were used for the analysis. There were no significant differences between the two groups in terms of sex, years of education, employment and household income. However, the residents who had reported USC were significantly older than the other residents. At the beginning of analyses, as mentioned previously, we excluded 14 items that indicated great floor and ceiling effects using descriptive statistics.

The preliminary number of items those retained was 81 in all. Six common factors were extracted based on the initial exploratory factor analysis. We gave each extracted factor a name: As a result, of the preliminary number of items those retained were as follows: As demonstrated in Table 2 , factor loadings of the retained items ranged from 0.

In addition, the Spearman correlation coefficients between the JPCAT total score and the overall user satisfaction was 0. The item-total correlation ranged from 0. Table 3 presents a summary of the results of the tests of Likert scaling assumptions using the six revised multi-item scales. In this way, we are making efforts to contribute to Japanese language education all over the world. On this page, we will introduce some of the projects that were carried out in the fiscal year.

At the end of March , its trial version was completed.

Considering the usage in Japanese educational programs in a 15 week-unit based on university term systems, we structured the program with 2 books, containing 26 sections in total. The first book Section 1 to 13 covers the first half of the beginner level, and the second book Section 14 to 26 covers the second half. Listening, reading and Kanji Chinese characters practice corresponding to each section have been included at the end of each book. The contents are designed to train the students and help them to acquire and develop general Japanese skills.

We accumulated the data in a digitized format, along with basic writing information. We intend to utilize their data for the benefit of Japanese language education and the study of Japanese language education.

We set the fiscal year as the preparatory period, and we spent 2 years actually collected the compositions from to In total, we were able to gather about 1, composition items, over all the trimester-periods of the 2 years.

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