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result(s) for
"Soriano, Krishan"
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Development and Content Validation of a Person-Centered Care Instrument for Healthcare Providers
by
Betriana, Feni
,
Miyagawa, Misao
,
Onishi, Kaito
in
Clinical outcomes
,
Collaboration
,
Compassion
2025
Background/Objectives: Despite the increasing recognition of person-centered care (PCC), existing evaluation tools often have profession-specific limitations, lacking broad applicability across interdisciplinary contexts. This study aimed to develop and validate the Person-Centered Care Instrument (PCCI), designed to assess the competence of healthcare providers from diverse professions. Methods: Using a two-round modified Delphi technique, ten experts validated an initial pool of 63 items. The process assessed both face validity (overall appropriateness) and content validity using a 9-point Likert scale and the Item-level Content Validity Index (I-CVI). Items with a median rating of 6 or higher and an I-CVI of ≥0.70 were retained. Results: The final PCCI consists of 37 items, with a scale-level content validity index of 0.65. Three items achieved universal agreement among the experts (I-CVI = 1.0). For the final 37-item PCCI, the Scale-level Content Validity Index (S-CVI) was 0.65, and the index based on universal agreement was 0.22. Conclusions: The developed PCCI demonstrated good face and content validity, making it a valid and broadly applicable tool for assessing competence in delivering PCC. This instrument can support quality improvement initiatives and help promote a culture of empathy and respect in healthcare.
Journal Article
Patient Satisfaction in Person-Centered Physical Rehabilitation for Patients with Schizophrenia: A Scoping Review
by
Betriana, Feni
,
Schoenhofer, Savina
,
Blaquera, Allan Paulo
in
Chronic illnesses
,
Collaboration
,
Decision making
2025
Person-centered care emphasizes shared decision-making and a holistic approach to support patient autonomy. This scoping review aimed to clarify the definitions and approaches of person-centered physical rehabilitation (PCPR) that satisfy patients with schizophrenia and to identify specific methods to increase their satisfaction. Methods: This scoping review was conducted in accordance with the recommendations of the Joanna Briggs Institute and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. The studies were screened, the data were extracted, and the findings were charted. Results: PCPR is an individually optimized rehabilitation approach that is centered around the “person” and is aimed at supporting the entire life of the individual, while respecting their values and wishes. This approach emphasizes the importance of patients actively participating in their own treatment and enhancing their self-management abilities rather than relying solely on medical techniques. PCPR involves empowering patients, particularly patients with schizophrenia; establishing comprehensive rehabilitation plans; and adopting flexible responses. Conclusions: Effective PCPR enhances healthcare providers’ moral sensitivity and ability to manage complex needs, thereby improving patient satisfaction and motivation to join physical rehabilitation. Furthermore, to conduct PCPR for patients with schizophrenia effectively, it is crucial to provide not only physical rehabilitation, but also appropriate psychosocial support, and to promote the establishment and maintenance of healthy lifestyle habits.
Journal Article
Physical Rehabilitation Patterns and Clinical Categorization in a Japanese Psychiatric Hospital: A Retrospective Content Analysis
by
Edo, Shoko
,
Onishi, Kaito
,
Blaquera, Allan Paulo
in
Activities of daily living
,
Chronic illnesses
,
Dementia
2026
The rising prevalence of physical comorbidities among patients with mental illness has increased the relevance of physical rehabilitation within psychiatric care. However, specific physical rehabilitation practices in specialized psychiatric hospitals in Japan remain insufficiently documented. This exploratory and descriptive study aimed to characterize the rehabilitation content provided and to categorize patient characteristics and comorbidities in a single specialized psychiatric hospital using an expert-led consensus approach. Clinical data from 150 patients (median age 71.0 years) who received physical rehabilitation were retrospectively analyzed. Patient categorization was conducted through a multidisciplinary consensus-building process involving an expert panel of physical therapists, occupational therapists, psychiatrists, and nurses, each with over 10 years of clinical experience. Using a hierarchical rule set based on International Classification of Diseases, 10th Revision (ICD-10) codes and clinical referral data, five distinct categories were identified: Disuse Syndrome (41%), Neurologic Disorders (20%), Lower Limb Lesions (18%), Parkinson’s Syndrome (15%), and Upper Limb Lesions (6%). Across all categories, rehabilitation interventions focused on foundational motor therapies, such as range of motion (27%) and strength training (23%). Mobility-oriented interventions were selectively provided to patients with high bedridden status based on clinical potential. Overall, practices in this setting primarily targeted disuse syndrome and maintenance of basic motor function and were delivered with input from multiple professional disciplines; such practices may inform future research on structured multidisciplinary rehabilitative approaches, especially for aging psychiatric populations.
Journal Article
Longitudinal Changes of BMI and Renal Function Biomarkers During the Final 3 Years of Life Among Hospitalized Patients with Schizophrenia in Japan: A Preliminary Study
by
Tang, Anson Chui Yan
,
Umehara, Hidehiro
,
Mifune, Kazushi
in
albumin levels
,
Antipsychotics
,
Biomarkers
2025
Patients with schizophrenia face high mortality from physical comorbidities; nonetheless, the gradual physiological decline preceding death is not well characterized. This retrospective study investigated temporal changes in key biomarkers among 64 inpatients with schizophrenia who died between 2014 and 2022. We analyzed data on body mass index (BMI), serum albumin (ALB), blood urea nitrogen/creatinine ratio (BCR), blood urea nitrogen/ALB ratio (BAR), and estimated glomerular filtration rate (eGFR) collected at five time points: 3, 2, and 1 year, 6 months before death, and prior to death. We hypothesized that these markers would exhibit significant changes during the last 3 years of life. BMI and ALB significantly decreased, while BCR and BAR increased (all p < 0.001). This pattern was also noted in the pneumonia subgroup, the leading cause of death (47%). A high BCR concomitant with low eGFR was attributable to chronic kidney failure in only 6% of patients, suggesting the elevated ratio was mostly driven by non-renal factors such as dehydration or sarcopenia. Therefore, the concurrent decline in BMI and ALB and rise in BCR and BAR represent a pattern of terminal physiological decline among patients with schizophrenia, supporting the need for timely risk assessment.
Journal Article
Refinement and Preliminary Validation of the Technological Competency as Caring in Healthcare Instrument (TCCHI): Psychometric Evaluation of a Concise Three-Factor Model
2026
Background/Objectives: With the increasing need for interprofessional team-based care, a practical framework is necessary to evaluate the caring competencies of healthcare providers. This study aimed to develop a refined, concise version of the Technological Competency as Caring in Healthcare Instrument (TCCHI) by: (1) reducing the items from the original 38-item Delphi-validated pool through confirmatory factor analysis (CFA) and (2) providing a preliminary assessment of its structural validity and reliability. Methods: An online survey was conducted with 528 healthcare professionals across Japan. The CFA process began with the 38 items identified in a previous Delphi study. To optimize model fit and ensure interprofessional applicability, items were systematically refined based on both statistical criteria and theoretical relevance, resulting in a 12-item, three-factor structure. Results: The final 12-item model demonstrated an improved and generally acceptable fit: chi-square to degrees of freedom ratio (χ2/df) = 3.96, comparative fit index (CFI) = 0.947, Tucker–Lewis Index (TLI) = 0.931, and Root Mean Square Error of Approximation (RMSEA) = 0.0749. All factor loadings were statistically significant (p < 0.001) and ranged from 0.437 to 0.83. Composite reliability (CR) for the three factors ranged from 0.700 to 0.827, meeting the threshold for internal consistency. While average variance extracted (AVE) values for some factors were below 0.50, the overall model provided a stable and theoretically consistent structure, albeit as a preliminary psychometric refinement. Conclusions: This study provides preliminary evidence for the structural validity and reliability of a refined 12-item, three-factor TCCHI. By offering a concise measurement tool aligned with caring theory, the TCCHI has the potential to support interprofessional assessment, education, and professional development in technology-mediated healthcare environments. However, further research is required to address issues of discriminant validity and confirm measurement invariance across different professional groups.
Journal Article
Development of Perceived Technological Competency as Caring in Healthcare Providers Instrument (TCCHI): A Modified Delphi Method
by
Betriana, Feni
,
Miyagawa, Misao
,
Kataoka, Mutsuko
in
Analysis
,
Artificial intelligence
,
Delphi method
2025
Background/Objectives: This study aimed to develop the Technological Competency as Caring in Healthcare Providers Instrument (TCCHI) for multidisciplinary use, based on Locsin’s theory of Technological Competency as Caring in Nursing. Methods: A content validation design employing a modified Delphi technique was conducted with a multidisciplinary panel of 10 healthcare experts (recruited by purposive sampling based on expertise in technology/caring). The preliminary 67-item pool was derived from a literature review and theoretical alignment. Two Delphi rounds were implemented to establish face and content validity. Qualitative feedback from Round 1 guided item refinement for Round 2. The Wilcoxon matched-pairs signed-rank test was used to confirm the response stability between rounds. Results: Among the 67 initial items, 38 were retained after two Delphi rounds, achieving an I-CVI of 0.80–0.90. Response stability was established (p > 0.05). The resulting 38 items were categorized into six refined concepts reflecting the integration of technology and caring. Inter-rater consistency, assessed by the Intraclass Correlation Coefficient (ICC), was moderate (Round 1 ICC = 0.49; Round 2 ICC = 0.50), suggesting initial variability among the multidisciplinary panel. Conclusions: The TCCHI is a comprehensive and theoretically grounded instrument applicable across diverse healthcare disciplines. However, the moderate inter-rater consistency suggests that further empirical validation is required. Further psychometric evaluation, including confirmatory factor analysis and internal consistency reliability testing, is required to establish construct validity and strengthen the instrument’s applicability in diverse healthcare settings.
Journal Article
Gait Disturbance in Patients with Schizophrenia in Relation to Walking Speed, Ankle Joint Range of Motion, Body Composition, and Extrapyramidal Symptoms
2025
Background/Objectives: In patients with schizophrenia, gait disturbances (e.g., reduced walking speed and stride length) are linked to neural dysfunction and extrapyramidal symptoms. To inform gait rehabilitation strategies, this study examines the relationships of walking speed with extrapyramidal symptoms, stride length, antipsychotic dosage, ankle joint range of motion, and body composition in patients with chronic schizophrenia. Methods: Sixty-eight patients with chronic schizophrenia were included. All variables were described based on their measurement levels using non-parametric methods. Spearman’s rho was calculated to assess correlations. For multiple linear regression analyses, backward stepwise elimination was used to determine variables associated with walking speed. Statistical significance was set to p < 0.05. Results: Walking speed was positively correlated with stride length, chlorpromazine-equivalent dose, ankle plantar flexion, body mass index, bone mineral content, trunk muscle mass, and skeletal muscle mass index. In contrast, it was negatively correlated with drug-induced extrapyramidal symptoms scale (DIEPSS) scores for gait, bradykinesia, tremor, overall severity, and age. The multiple linear regression indicated that DIEPSS 2 bradykinesia level and ankle plantar flexion angle, adjusted for a 26% variance, best explained the walking speed. Conclusions: A lower bradykinesia severity and a higher ankle plantar flexion are associated with higher walking speeds. Thus, it is critical to assess stride length, bradykinesia, angle/limitation/torque of ankle plantar flexion, trunk and upper and lower limb muscle masses, and walking speed in patients with chronic schizophrenia. Specific strategies for gait rehabilitation should focus on stride training, plantar flexion strengthening exercises, and balance training.
Journal Article
Association Between Dynapenia/Sarcopenia, Extrapyramidal Symptoms, Negative Symptoms, Body Composition, and Nutritional Status in Patients with Chronic Schizophrenia
by
Umehara, Hidehiro
,
Tanioka, Ryuichi
,
Mifune, Kazushi
in
Activities of daily living
,
Antipsychotics
,
Body composition
2025
Background/Objectives: This study aimed to determine the association between chronic schizophrenia, extrapyramidal symptoms (EPSs), body composition, nutritional status, and dynapenia/sarcopenia. Methods: Data from 68 chronic patients with schizophrenia were analyzed using Spearman’s rho correlation coefficients, Kruskal–Wallis test, Mann–Whitney U test, and Cramér’s V statistics. Results: Among the participants, 32.4% had no loss of muscle mass or function, 39.7% had dynapenia, and 27.9% had sarcopenia. This study identified five key findings: (1) Bilateral grip strength, skeletal muscle index, and walking speed are interrelated, with higher negative symptom scores linked to slower movement and rigidity, particularly in the sarcopenia group, indicating that negative symptoms may contribute to muscle weakness and progression to sarcopenia. (2) Increasing age is associated with a decrease in chlorpromazine equivalent dose and an increase in the severity of EPSs. (3) Blood urea nitrogen (BUN)/creatinine ratio and all sarcopenia risk indicators were significantly negatively correlated. (4) Dynapenia and sarcopenia groups exhibited significant differences in muscle mass and nutritional status compared to the non-penia group, including reduced muscle mass, lower basal metabolic rate, and lower visceral fat levels. (5) There was an association between the Barthel Index (BI) score for activities of daily living (ADL) and dynapenia/sarcopenia. Particularly with regard to ADL, it seems necessary to pay attention to muscle weakness in partially independent patients who score 60 points or more. Conclusions: BUN/creatinine ratio, BI, EPSs, body mass index, grip strength, total protein, and albumin were useful indicators for detecting the risk of dynapenia/sarcopenia in routine psychiatric care.
Journal Article