Patients' desire to participate in decision-making in psychiatry: a questionnaire survey in Japan

Japanese national sentiment has been described as paternalistic, which has potentially wide-ranging implications for the manner in which psychiatric patients should participate in medical decision-making. To examine the extent and possible determinants of the desire to participate in medical decision-making among Japanese people, we distributed a packet of questionnaires to 747 (nonmedical) university students and 114 of their parents. The questionnaires included an imaginary case vignette of psychotic depression. The participants were asked whether they would want various types of medical information, i.e., diagnosis, aetiology, treatment, outcomes, medical charts, etc., disclosed to them were they in such a psychiatric condition. Also included was the 1995 Scale for Independent and Interdependent Construal of the Self by Kiuchi. More than half of the participants wanted all the types of medical information disclosed to them. Those participants who wanted to have all types of information disclosed to them (n = 413) as compared to those who did not want to know at least one type of information (n = 445), tended to be male and to have an educational background in psychiatry (9.7% vs 5.4%) as well as an assertive attitude as indicated by a higher score on Independence on the Scale for Independence and Interdependent Construal of the Self. These results suggest that the Japanese in this sample are more likely to want to make an autonomous contribution to the psychiatric decision-making process and that less desire for information can be predicted by some demographic and personality factors.     

Alcohol Use,Acculturative Stress,and Drinking Motivation Among International Community College Students

Alcohol use, acculturative stress, and drinking motivations of 262 students in English as a second language programs in a U.S. community college were explored. Alcohol consumption was generally low, but differences between two groups with different legal statuses indicate the need to consider subgroups of international students for research purposes. Se exploraron el uso de alcohol, el estrés por aculturación y las motivaciones para beber de 262 alumnos en programas de inglés como lengua extranjera en una universidad comunitaria estadounidense. El consumo de alcohol fue moderadamente bajo, pero las diferencias entre dos grupos con diferente estatus legal indican la necesidad de considerar subgrupos de estudiantes internacionales a la hora de realizar investigaciones.     

Neck formation processes of nanocrystalline silicon carbide: A tight-binding molecular dynamics study

Atomistic and electronic structures in the process of intergranular neck formation of nanocrystalline silicon carbide (SiC) have been investigated by a tight-binding molecular dynamics method. An order-N parallel algorithm is employed for efficient calculations of electronic energy and forces. We find that a defect-free neck is formed between SiC nanocrystals aligned along [112] axis at T     

Factor structure of the FACES-III in Japanese university students

We performed a confirmatory factor analysis for the Family Adaptability and Cohesion Evaluation Scale (FACES-III) using 3865 university students in Japan. We confirmed two factors as in the original version, but there were slight differences with the original one. Some items were deleted in order to obtain sufficient goodness-of-fit indexes in a series of confirmatory factor analyses. Moreover, items 11 "Our family, changes its way of handling tasks," 20 "Parents and children discuss in our family," and 15 "We shift household responsibilities," which were originally categorized as "adaptability" items, were loaded on the "cohesion" factor.     

Association of maternal smoking during pregnancy and infant neurobehavioral status

The association of maternal smoking during pregnancy with neurobehavioral status was examined in 344 Japanese infants. Based on a questionnaire, their mothers were classified into three groups, Nonsmokers, Exsmokers, and Smokers. The Neonatal Behavioral Assessment Scale was administered three days after birth. Among the three groups, on the seven clusters and their 28 behavioral subscales there were no significant differences. The infants of Smokers had lower scores than those of Exsmokers and Nonsmokers on two behavioral items, general tone and peak of excitement. General tone remained significant after adjustment for covariates.     

Respecting autonomy in difficult medical settings: a questionnaire study in Japan

Some people in Japan are still comfortable with the paternalistic role of doctors, but others wish that their own decisions would receive a greater amount of respect. A total of 747 students of universities and colleges and 114 parents of these students participated in a questionnaire survey. Most of the participants thought that autonomy should be respected in situations involving death with dignity and euthanasia, whereas it should not be respected in attempted suicide and involuntary admission of individuals with mental illness. A cluster analysis revealed that the participants could be divided into the following groups: aid in dying advocates (n=577), complete libertarians (n=109), protectors of the mentally ill (n=90), complete paternalists (n=29), and questionables (n=27). The assertion of independence score of the Scale for Independent and Interdependent Construal of the Self showed a significant difference among the 5 clusters. These findings suggest that the traditional paternalistic relationship between doctor and patient is undergoing a gradual transformation in Japan.