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Background“Recovery” is a central concept in mental health, particularly for mental health services and policy-makers. The present study examined the factorial and concurrent validity, internal consistency reliability, and test–retest reliability of the Japanese version of the 7-item Recovery Attitudes Questionnaire (RAQ) among mental health service providers in community and inpatient settings in Japan.MethodsWe conducted a cross-sectional questionnaire with a number of eligible professional groups, including psychiatrists, registered/assistant nurses, public health nurses, clinical psychologists, pharmacists, occupational therapists, and social workers. Participants were drawn from two psychiatric hospitals and 56 psychiatric clinics or community service agencies. In total, 331 participants completed the questionnaire. After excluding those with missing RAQ values, 307 participants were included in the analysis; the participants’ mean age was 40.2 years and 29.6 % were men. The questionnaire comprised the Japanese version of the 7-item RAQ developed by the present authors, the revised scale of the positive attitudes of staff toward persons with mental disorder (the positive attitudes scale), and the Japanese-language version of the Social Distance Scale (SDSJ). Confirmatory factor analyses were used to examine factorial validity of a two-factor structure reported in a previous study (Borkin et al., 2000) as well as a single-factor structure. Concurrent validity was determined by calculating correlations between RAQ and the other two scales. Internal consistency reliability was assessed with Cronbach’s alpha coefficients and inter-item correlations. Test–retest reliability was assessed by the intraclass correlation coefficient (ICC), with a weighted kappa in a subsample of participants (n = 13).ResultsThe two-factor structure showed acceptable factorial validity. RAQ scores were significantly and positively correlated with the positive attitudes scale, and there was a significant inverse correlation with the SDSJ (p < 0.01). The RAQ had an overall Cronbach’s alpha coefficient of 0.64. Four inter-item correlations were not significant. The ICC and weighted kappa values indicated unsatisfactory test–retest reliability.ConclusionThe Japanese RAQ showed acceptable factorial validity, reasonable concurrent validity, and unsatisfactory reliability in community and inpatient mental health settings in Japan. Further large-scale research is required to ensure robust verification.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0740-x) contains supplementary material, which is available to authorized users.

The Self-Identified Stage of Recovery (SISR) is a two-part scale assessing both the stage of recovery (SISR-A) and the component processes of recovery (SISR-B) for people with mental illness. This study aimed to develop a Japanese version of the SISR and to examine its reliability and validity. The Japanese versions of the SISR-A and SISR-B were developed through focus group cognitive interviews and the translation-back translation procedure. A cross-sectional questionnaire survey was conducted of 223 participants who had long term mental illness, were aged 20 years or older, and currently living in communities and inpatient ward settings; 59.2% were males and the average age was 47.6 years. The questionnaire also included the 24-item Recovery Assessment Scale, Herth Hope Index, Empowerment Scale, and Resilience Scale. Cronbach's alpha coefficient, intraclass correlation coefficient, and weighted kappas were generally fair to high, and the SISR-A and SISR-B scores were positively correlated with other relevant scales. This study supported the reliability and validity of the Japanese versions of the SISR-A and SISR-B among people with long term mental illness in Japan.

BackgroundThe Recovery Knowledge Inventory (RKI) is one of the influential scales to assess knowledge and attitude toward recovery-oriented practices among mental health service providers. In the present study, we aimed to develop a Japanese version of RKI and examine the validity and reliability.MethodsWe translated RKI into Japanese by reference to the guidelines for translating and adapting psychometric scales. A cross-sectional questionnaire survey was conducted with mental health service providers. Of a total of 475 eligible professionals, we used data from the 299 participants without missing value for the analyses (valid response rate = 62.9%). The questionnaire included Japanese RKI, Recovery Attitudes Questionnaire, The positive attitudes scale, and Japanese-language version of the Social Distance Scale. To examine the factorial validity of RKI, explanatory factor analysis and confirmatory factor analysis was employed. Convergent validity was assessed by calculating Pearson’s correlation coefficients between the total RKI score and the scores for the other three scales. We also calculated Cronbach’s α coefficients for the total score and for each domain of RKI to assess internal consistency reliability.ResultsThe participants’ mean age was 40.4 years and 30.4% were men. 20-item RKI did not provide any adequate or interpretable factor solutions at any number of factors by EFAs. Thus four items (#1, 4, 5, and 13) were subsequently eliminated in stages, then 16-item RKI was employed as a consequence for further analyses. EFA with four factor structures yielded marginally interpretable constitution. Each factor represented the knowledge regarding psychiatric symptoms and recovery; knowledge about the recovery process; the understanding of what is important for recovery; and the understanding of the challenges and responsibility in recovery, respectively. Subsequent CFA suggested good fit to the data. Good convergent validity and understandable internal consistency reliability were also observed.ConclusionsThe Japanese 16-item RKI revealed reasonable factorial validity, good convergent validity, and understandable internal consistency reliability among mental health professionals. Japanese cultural settings seemed to influence the four-factor structure in the present study. It can be used for future study in Japan, while future large-scale research is required to ensure robust verification.

Background: Work engagement (WE) is defined as a positive, fulfilling, and work-related state of mind. Enhancing WE leads to positive outcomes in both individuals and organizations. Although cultural factors may influence the antecedents and outcomes of WE, no reviews summarized these factors among nurses, mainly in Asia. This review aimed to identify the antecedents and outcomes of WE among nurses in Japan. This may offer novel insights into the influencing factors on WE. Methods: A literature search was conducted using six data sources: PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycINFO, Business Source Premier, Ichushi-Web, and CiNii. A total of 38 studies met the inclusion criteria. Studies that included registered nurses and/or midwives at hospitals or facilities were included in this review. The antecedents and outcomes were classified into four themes based on the job demands–resources model (JD-R model). Findings: Many variables in three components of the JD-R model (i.e., job resources, personal resources, and favorable outcomes) exhibited positive relationships with WE as theorized. Many other variables in job demands demonstrated negative relationships with WE as hypothesized. Many factors that were identified in this review were consistent with the JD-R model. The model in turn was found to be applicable among nurses. The antecedents and outcomes in this review were similar to those in previous studies in Western countries, while this review also revealed teamwork nursing as a possible antecedent of WE, which has not previously been reported. Conclusion/Application to Practice: Improving job resources (e.g., teamwork nursing) and personal resources may effectively enhance WE among Japanese nurses.

Little scientific evidence exists on ways to decrease the psychological stress experienced by disaster responders, or how to maintain and improve their mental health. In an effort to grasp the current state of research, we examined research papers, agency reports, the manuals of aid organisations, and educational materials, in both English and Japanese. Using MEDLINE, Ichushi-Web (Japanese search engine), Google Scholar, websites of the United Nations agencies, and the database of the Grants System for Japan's Ministry of Health, Labour, and Welfare, 71 pertinent materials were identified, 49 of which were analysed. As a result, 55 actions were extracted that could potentially protect and improve the mental health of disaster responders, leading to specific recommendations. These include (1) during the pre-activity phase, enabling responders to anticipate stressful situations at a disaster site and preparing them to monitor their stress level; (2) during the activity phase, engaging in preventive measures against on-site stress; (3) using external professional support when the level of stress is excessive; and (4) after the disaster response, getting back to routines, sharing of experiences, and long-term follow-up. Our results highlighted the need to offer psychological support to disaster responders throughout the various phases of their duties.

Recovery is defined as the process of developing new meaning and purpose in life as one grows beyond the catastrophic effects of mental illness. This study aimed to develop a program to facilitate recovery and examine its effectiveness in a randomized controlled trial. The program was developed with three components that enhance benefit finding, personal meaning, and a sense of happiness. Sixty-three participants with long-term mental illness were randomly allocated to the intervention group (n = 32) or the control group (n = 31). The intervention group attended eight 2-h group sessions, with one held every week. Recovery was assessed at baseline, post-intervention, and at a three-month follow-up. In the per-protocol analysis, after excluding those who dropped out, the intervention group showed significant improvement in recovery compared with the control group (P < 0.05). In the intention-to-treat analysis, a repeated measures analysis of variance did not show any significant intervention effect (time × group) (P > 0.05). The program had the potential to facilitate recovery.

This study quantitatively examined the association between recovery and benefit-finding among persons with a chronic mental illness in Japan. A cross-sectional questionnaire survey was conducted, with responses from 237 (74%) of 319 individuals (≥ 20 years old) with a chronic mental illness in community and inpatient ward settings. The data of 120 questionnaires were analyzed (men, 64%; average age, 41 years). The questionnaire included the Recovery Assessment Scale (RAS) and Self-identified Stage of Recovery Parts A and B (SISR-A and SISR-B) for assessing recovery and the Perceived Positive Change Scale (PPCS) for assessing benefit-finding. The total RAS and SISR-B scores strongly and positively correlated with the PPCS score. The PPCS score significantly differed among the recovery stages, as classified by the SISR-A, with higher scores at higher stages; the association was almost linear. The study confirmed the theoretically expected relationship between recovery and benefit-finding among these individuals. Benefit-finding might be associated not only with a higher stage of recovery but also with each step from one stage to another.