Development of livelihood difficulties assessment scales for clinicians
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- NISHIOKA Daisuke
- Department of Health Education and Health Sociology, Graduate School of Medicine, The University of Tokyo
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- UENO Keiko
- Department of Health Education and Health Sociology, Graduate School of Medicine, The University of Tokyo
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- FUNAKOSHI Mitsuhiko
- Chidoribashi Hospital
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- SAITO Masashige
- Department of Social Welfare, Faculty of Social Welfare, Nihon Fukushi University
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- KONDO Naoki
- Department of Health Education and Health Sociology, Graduate School of Medicine, The University of Tokyo
Bibliographic Information
- Other Title
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- 医療機関で用いる患者の生活困窮評価尺度の開発
- イリョウ キカン デ モチイル カンジャ ノ セイカツ コンキュウ ヒョウカ シャクド ノ カイハツ
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Abstract
<p>Objectives Poverty is a well-known major social determinant of health. Poverty has been conceptualized as multidimensional livelihood difficulties that include material deprivation, financial difficulties, and social isolation. Through their clinical practice, some health care institutions have tried to address social risks among patients. However, standardized assessment tools that can detect patients’ livelihood difficulties are not well established. The aims of this study were to develop brief screening tools to assess patients’ livelihood difficulties, and to examine the validity and reliability of these tools in Japanese health care institutes.</p><p>Methods We used secondary data from a cross-sectional questionnaire survey. The respondents of the survey were adult patients from five hospitals belonging to Japan Health Promoting Hospitals and Service Networks. The questionnaire included 25 questions that assessed patients’ poverty. An iterated principal factor analysis with Promax rotation was performed and scales to assess patients’ livelihood difficulties were developed. This was followed by an examination of the scales’ validity and internal consistency using standardized Cronbach's alpha. Further, we built brief assessment tools by selecting questions that showed high factor loading.</p><p>Results A total of 265 participants were included in the study. The response rate was 75.1%. The results of factor analysis suggested that data was affected by patients’ financial difficulties and social isolation. Eight questions on the financial difficulty scale and five questions on the social isolation scale showed factor loadings greater than 0.40. The standardized Cronbach's alpha coefficient was 0.88 for the financial difficulty scales and 0.74 for the social isolation scales. Finally, a brief assessment tools that included two questions from each scale was developed.</p><p>Conclusion This tool may be used as a screening tool for patients’ livelihood difficulties in the health records of each clinic/hospital, and may help patients effectively receive integrated medical and social care. In order to use this scale in practice, under a well-established community-based integrated care system, it may be necessary to establish a standardized scoring system and diagnostic threshold to verify the generalizability of the scale at healthcare institutes with different characteristics.</p>
Journal
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- Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH)
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Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH) 67 (7), 461-470, 2020-07-15
Japanese Society of Public Health
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Keywords
Details 詳細情報について
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- CRID
- 1390848250132988672
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- NII Article ID
- 130007882594
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- NII Book ID
- AN00189323
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- ISSN
- 21878986
- 05461766
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- NDL BIB ID
- 030538640
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- PubMed
- 32741877
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- PubMed
- CiNii Articles
- KAKEN
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- Abstract License Flag
- Disallowed