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ObjectivesAlthough it is understood that work-related factors, including job demands, job control, and workplace support, are associated with workers' health and well-being, the role played by personal characteristics, especially workaholism, has not been fully investigated. This study examined workaholism's associations with psychological ill health, low back pain with disability, and sickness absence among Japanese workers.MethodsA cross-sectional Internet survey was conducted using self-administered questionnaires. Data from 3,899 Japanese workers were analyzed. Workaholism was measured using the Dutch Workaholism Scale (DUWAS). Scores were divided into tertiles, where respondents were classified into three groups (high, middle, and low). Depressive mood as a measure of psychological ill health was assessed using the SF-36 mental health subscale, and low back pain using a standardized question. Sickness absence, except that due to physical injuries, was categorized either as absence due to mental health problems or to physical/somatic problems including the common cold. Multiple logistic regression analyses were conducted to examine the association between workaholism and depressive mood, low back pain with disability, and sickness absence, adjusting for demographic characteristics, job demand, job control, and workplace support.ResultsCompared to the low workaholism group, the middle and high workaholism groups had significantly higher odds for depressive mood (Odds ratio (OR) = 1.93 and 3.62 for the middle and high groups, respectively), disabling back pain (ORs = 1.36 and 1.77 for the middle and high groups, respectively). Workaholism was more strongly associated with sickness absence due to mental health problems than that for other reasons (ORs = 1.76 vs. 1.21 for the middle group and 3.52 vs. 1.37 for the high groups).ConclusionsWorkaholism is significantly associated with poor psychological health, disabling back pain, and sickness absence, particularly from mental health problems. Therefore, workaholism must be considered when addressing well-being of workers.

ObjectiveTo describe the burden associated with different anti-vascular endothelial growth factor (VEGF) treatment strategies for wet age-related macular degeneration (wAMD) in a real-word setting in Japan.MethodsSingle-center, cross-sectional survey of caregivers of patients with wAMD performed in a hospital in Mito-City, a rural area in Japan. Caregiver burden was evaluated using the Burden Index of Caregivers (BIC-11), and depressive symptoms were assessed by the Center for Epidemiologic Studies Depression scale. Retrospective medical chart review was conducted to monitor resource use and visual acuity outcomes in patients. The productivity loss of caregivers accompanying patients on hospital visits was estimated using the human capital method.ResultsSeventy-one patient-caregiver pairs were included. Most caregivers were female (74.6%), spouse/partner (54.9%), employed (46.5%), and the primary caregiver (85.9%). Patients received anti-VEGF treatment as follows: treat-and-extend (T&E; n = 42), switch (from as-needed [PRN] to T&E; n = 18), PRN (n = 10), and other (n = 1). Caregiver-related burden (total BIC-11 scores) were 4.29 (T&E) 4.60 (PRN), and 5.33 (switch) (p = NS).The mean number of hospital visits was lower with T&E than PRN (7.88 vs. 14.0 [p = 0.00674] in year 1 and 5.68 vs. 9.0 in year 2). For patients who switched from PRN to T&E, the mean number of hospital visits decreased from 13.21 to 7.43 (p<0.0001) in the first year after switch. The productivity loss associated with accompanying patients to the hospital was lower for caregivers of patients receiving T&E than PRN (mean differences: 74,456.04 JPY [p = 0.00284] in year 1 and 40843.14 JPY in year 2), and was also reduced for caregivers of patients who switched from PRN to T&E.ConclusionwAMD treatment with anti-VEGF agents via T&E reduced hospital visits compared with PRN, where associated monitoring visits are necessary to provide good patient outcomes. T&E was associated with a reduction trend in caregiver burden, including time and costs.

Background and ObjectiveThe STarT Back Tool uses prognostic indicators to classify patients with low back pain into three risk groups to guide early secondary prevention in primary care. The present study aimed to evaluate the psychometric properties of the Japanese version of the tool (STarT-J).MethodsAn online survey was conducted among Japanese patients with low back pain aged 20–64 years. Reliability was assessed by examining the internal consistency of the overall and psychosocial subscales using Cronbach’s alpha coefficients. Spearman’s correlation coefficients were used to evaluate the concurrent validity between the STarT-J total score/psychosocial subscore and standard reference questionnaires. Discriminant validity was evaluated by calculating the area under the curves (AUCs) for the total and psychosocial subscale scores against standard reference cases. Known-groups validity was assessed by examining the relationship between low back pain-related disability and STarT-J scores.ResultsThe analysis included data for 2000 Japanese patients with low back pain; the mean (standard deviation [SD]) age was 47.7 (9.3) years, and 54.1% were male. The mean (SD) STarT-J score was 2.2 (2.1). The Cronbach’s alpha coefficient was 0.75 for the overall scale and 0.66 for the psychosocial subscale. Spearman’s correlation coefficients ranged from 0.30 to 0.59, demonstrating moderate to strong concurrent validity. The AUCs for the total score ranged from 0.65 to 0.83, mostly demonstrating acceptable discriminative ability. For known-groups validity, participants with more somatic symptoms had higher total scores. Those in higher STarT-J risk groups had experienced more low back pain-related absences.ConclusionsThe overall STarT-J scale was internally consistent and had acceptable concurrent, discriminant, and known-groups validity. The STarT-J can be used with Japanese patients with low back pain.

PurposeThe Zurich Claudication Questionnaire (ZCQ) is a self-administered measure to evaluate symptom severity, physical function, and surgery satisfaction in lumbar spinal stenosis (LSS). The purpose of this study is to assess the psychometric properties of the Japanese ZCQ in LSS patients.MethodsLSS patients who are scheduled to undergo surgery were recruited from 12 facilities. Responses to several questionnaires, including the Japanese ZCQ; the visual analogue scale (VAS) to evaluate the degree of pain in the buttocks/legs, numbness in the buttocks/legs, and low back pain; the Oswestry Disability Index (ODI); and the SF-36v2, were collected before surgery and again 3 months after surgery (the post-surgery ZCQ was administered twice for test-retest reliability). For reliability, test-retest reliability was evaluated using the intra-class coefficient (ICC) and internal consistency was evaluated using Cronbach’s alpha coefficient. Concurrent validity was assessed using Spearman’s correlation coefficients between the Japanese ZCQ and other questionnaires. Effect size (ES) and standard response mean were calculated for responsiveness. All analyses were performed individually for the Japanese ZCQ symptom, function, and satisfaction domains.ResultsData from 180 LSS patients were used in this analysis. The ICCs were 0.81, 0.89, and 0.88 and Cronbach’s alpha coefficients were 0.78, 0.84, and 0.92 for the Japanese ZCQ symptom, function, and satisfaction domains, respectively. Regarding the concurrent validity, strong correlations (±0.5) were demonstrated between the Japanese ZCQ domains and the VAS leg pain, ODI, and SF-36v2 physical functioning or bodily pain, whereas correlations were approximately 0.3 in scales measuring other symptoms that are less related to symptom, function, or satisfaction domains. ESs showed high values for the ZCQ symptom and function domains (-1.73 for both).ConclusionsThese psychometric assessments demonstrate that the Japanese ZCQ is a psychometrically reliable and valid measure in LSS. The Japanese ZCQ can evaluate both multi-dimensional aspects and the level of surgery satisfaction.