Objectives
The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide. Since April 2016, Japanese national health insurance has covered nurse-administered cognitive behavioral therapy (CBT) for mood disorders. However, empirical support for nurse-led CBT for depression in Asian countries, especially in Japan, is still lacking. This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression.
Methods
In this single-arm study, we evaluated the effects of a 6-week group CBT, led by trained nurses, on patients with major depression. The primary outcome was the Beck Depression Inventory-II (BDI-II). Assessments were conducted at the beginning and end of the intervention.
Results
Of 25 participants screened, 23 were eligible for the study (of these, three dropped out during the trial but were included in the analysis). Nurse-led group CBT led to significant improvements in the severity of depression (BDI-II,
P
< 0.001). The mean total BDI-II score improved from 23.1 (
SD
= 7.56) to 12.4 (
SD
= 8.57), and the pre-to post-effect size was large (Cohen's
d
= 1.33). After CBT, 45% of the participants were judged to be treatment responders, and 34% met the remission criteria.
Conclusions
Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting. The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice. Further controlled trials that address the limitations of this study are required.
Aim
Japanese teachers are not only responsible for students but also for tasks outside the classroom, including engagement with parents and the community, and maintaining safety. They work longer hours and have lower self‐efficacy than teachers in other countries. Thus, we aimed to develop an assessment scale for job stress in teachers and to evaluate its psychometric properties.
Methods
We developed the “School Teachers Job Stressor Scale (STJSS) Draft” comprising 45 items, based on previous anonymous self‐report questionnaires collected from 98 teachers in four elementary and middle schools in Miyazaki City, Japan. Subsequently, the scale draft and the previously validated Brief Job Stress Questionnaire (23‐item abridged version) were distributed to 2276 teachers from 73 elementary and middle schools in Miyazaki City. Finally, we analyzed data from 1300 participants. After excluding inappropriate data based on ceiling and floor effect analysis, we carried out a good‐poor, item‐total correlation, and exploratory factor analyses. We then verified construct validity, criterion‐related validity, and reliability using correlation analysis, confirmatory factor analysis, and Cronbach's alpha, respectively.
Results
After item‐total correlation analysis, five items were excluded. Exploratory factor analysis extracted five factors: “Time spent outside of work,” “Self‐assessment of one's ability as a teacher,” “Relationship with other teachers,” “Social interactions outside of teaching,” and “Duties outside of teaching.” The final version of the STJSS comprised 23 items and five factors.
Conclusion
The 23‐item STJSS developed to measure specific stressors in Japanese teachers to improve their mental health care could provide an accurate assessment tool with adequate reliability and validity.
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