BackgroundThe Internet is known to be used for health purposes by the general public all over the world. However, little is known about the use of, attitudes toward, and activities regarding eHealth among the Japanese population.ObjectivesThis study aimed to measure the prevalence of Internet use for health-related information compared with other sources, and to examine the effects on user knowledge, attitudes, and activities with regard to Internet use for health-related information in Japan. We examined the extent of use via personal computers and cell phones.MethodsWe conducted a cross-sectional survey of a quasi-representative sample (N = 1200) of the Japanese general population aged 15–79 years in September 2007. The main outcome measures were (1) self-reported rates of Internet use in the past year to acquire health-related information and to contact health professionals, family, friends, and peers specifically for health-related purposes, and (2) perceived effects of Internet use on health care.ResultsThe prevalence of Internet use via personal computer for acquiring health-related information was 23.8% (286/1200) among those surveyed, whereas the prevalence via cell phone was 6% (77). Internet use via both personal computer and cell phone for communicating with health professionals, family, friends, or peers was not common. The Internet was used via personal computer for acquiring health-related information primarily by younger people, people with higher education levels, and people with higher household incomes. The majority of those who used the Internet for health care purposes responded that the Internet improved their knowledge or affected their lifestyle attitude, and that they felt confident in the health-related information they obtained from the Internet. However, less than one-quarter thought it improved their ability to manage their health or affected their health-related activities.ConclusionsJapanese moderately used the Internet via personal computers for health purposes, and rarely used the Internet via cell phones. Older people, people with lower education levels, and people with lower household incomes were less likely to access the Internet via cell phone. The Internet moderately improved users’ health-related knowledge and attitudes but seldom changed their health-related abilities and activities. To encourage communication between health providers and consumers, it is important to improve eHealth literacy, especially in middle-aged people. It is also important to make adequate amendments to the reimbursement payment system and nationwide eHealth privacy and security framework, and to develop a collaborative relationship among industry, government, and academia.

Background: The Barthel Index (BI) is a measure of independence in activities of daily living (ADL). In the modified Barthel Index (MBI), a five-point system replaced the original two or three or four point rating system. Based on this modified measure, the performance evaluation tool MBI (PET-MBI) was developed in Japan. Although the reliability and validity of PET-MBI have been verified for older people, the use of this tool in stroke patients has not been evaluated. This study investigated the validity and reliability of PET-MBI for stroke patients. Methods: Ten raters independently determined the BI and PET-MBI scores of stroke patients by direct observation. These patients' ADL were videotaped, and 10 other raters then evaluated the videos privately and assigned PET-MBI scores twice, one month apart. The criterion-related validity of the PET-MBI against the BI was evaluated using the correlation coefficients for their total scores. Furthermore, to assess inter-and intra-rater reliabilities from the results of the first and second sessions, Fleiss' intraclass correlation coefficients (ICCs) were calculated for the total scores, with the lower limits of the 95% confidence interval (95%CI), along with weighted kappa (κ w ) coefficients for agreement in individual tasks of this evaluation tool. ICC and κ w coefficients of 0.81-1.00 were considered to be "almost perfect" agreement.

[Purpose] This study aimed to examine the validity and internal consistency of the Japanese version of a performance evaluation tool for activities of daily living (ADL) based on the modified Barthel Index (PET-MBI) among elderly people at home. [Subjects] The subjects were elderly people living at home in Japan. [Methods] A cross-sectional study was performed at five home care facilities for elderly people in Japan. ADL performance was evaluated for 128 participants using the PET-MBI, which included 10 self-care items. We used confirmatory factor analysis to estimate the factorial validity. We assessed data model fitness with the χ2 statistic, the Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index (AGFI), and Root Mean Square Error of Approximation (RMSEA). Cronbach’s alpha coefficient was used to determine the internal consistency. [Results] The mean age of the participants was 79.1±8.9 years. Among the 126 participants included in the analysis, 67 were women (53.2%). The single-factor model demonstrated a fair fit to the data, with the χ2 statistic = 74.9 (df =35), GFI = 0.88, AGFI = 0.81, and RMSEA = 0.096, and the path coefficients of each item ranged from 0.44 to 0.95. The alpha coefficient of the 10-item scale was 0.93. [Conclusion] The PET-MBI for elderly people at home was well validated.

Subjects who had maintained a certain level of cognitive function, engaged in activities with friends, and went out frequently at baseline were extracted. In other words, the results suggested that enhancement of social networks and leisure activities prompted by recreational centre participation had a positive effect on maintaining cognitive function. The results also suggest that to improve the effectiveness of preventive interventions for cognitive dysfunction, support for social factors and leisure activities, in addition to cognitive function, may improve the long-term effectiveness of maintaining cognitive function.

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This study aimed to examine the validity and reliability of an instrument designed to assess the needs of institutionalized elderly. The instrument comprised 25 items covering 4 domains: basic activities of daily living, instrumental activities of daily living, environment and lifestyle, and emotion. These items were extracted from interviews with care providers of institutionalized elderly individuals. Confirmatory factor analysis showed that the model was validated ( n =120, χ 2 /df = 1.090, RMSEA = 0.03) and all standardized path coefficients ranged from .28 to .87. Internal consistency was high for each domain (Cronbach's alpha, .79 to .85). The reproducibility test ( n = 18) showed that 14 of 25 items showed weighted kappa coefficients ≥ .60 (i.e., substantial agreement). Therefore, we conclude that the present instrument was satisfactorily valid and reliable.

Aims: To establish the reliability and validity of a performance evaluation tool based on the modified Barthel Index (PET-MBI) for elderly residents of long-term care facilities. Methods: To develop the PET-MBI, the 10-task modified Barthel Index was translated into Japanese by three therapists, taking Japanese culture and lifestyles into account. Its reliability was independently assessed by two therapists who evaluated 16 participants (mean age 85.6 years; standard deviation (SD)=7.3) from one facility. The internal consistency and validity of the PET-MBI was then assessed by two therapists at three facilities, who evaluated a total of 110 participants (mean age 85.0 years; SD=7.1). Findings: We excluded the item ‘stair climbing’ because participants did not have to do this. Kappa coefficients of intra-tester reliability based on the test-retest method were 0.70–1.00 for individual tasks of the PET-MBI; kappa coefficients for inter-tester reliability were 0.72–1.00. Cronbach's coefficient alpha of internal consistency was 0.93. Factor analysis according to the PET-MBI revealed that a single factor explained self-care in elderly residents. Conclusions: The PET-MBI demonstrated high reliability, validity and internal consistency for the assessment of elderly residents in facilities.

Background: To promote active daily living and improve the quality of life of older facility residents, it is important that care staff understand their day-to-day activities and needs. However, only a few studies have examined the needs of older residents and how care workers understand them. This study aimed to examine the subjective needs of older residents at aged care facilities, care workers' understanding of these needs, and the gaps that exist between them.Methods: Structured interviews with older residents with no severe cognitive impairment in ten Japanese aged care facilities and a questionnaire survey of care workers were conducted in 2008 regarding resident subjective needs. The questionnaire, which had satisfactory factorial validity, internal consistency, and reproducibility, consisted of seven items on basic activities of daily living (BADL), five items on instrumental ADL (IADL), eight items on environment and lifestyle (EL), and five items on emotion (EM). Pair-wise analyses were performed to compare responses. Results:Responses of 115 pairs were analyzed (residents ≥75 years, 85 %; 21 men, 94 women). Median proportions of residents with IADL (66 %) and EL (69 %) needs were lower compared with those with BADL (83 %) and EM (91 %) needs. Median proportions of care workers understanding IADL (55 %) and EL (60 %) needs were lower compared with those understanding BADL (87 %) and EM (87 %) needs. Less than half of the care workers understood IADL needs for household chores (30 %) and money management (43 %), and an EL need for playing a role (41 %). Conclusions:Gaps were found between resident subjective needs and how care workers understood them. Specifically, care workers underestimated older residents' IADL and EL needs, especially with regard to playing a role. These results highlight the need for care workers to set goals based on each resident's subjective needs and plan strategies for care provision accordingly.