Machiko Inoue

Hamamatsu University School Of Medicine

Background The role of a patient’s functional health literacy (HL) has received much attention in the context of diabetes education, but researchers have not fully investigated the roles of communicative and critical HL, especially in primary care. Communicative HL is the skill to extract health information and derive meaning from different forms o...

Background: Tools for assessing quality of primary care from patient experience have never previously existed in Japan. Objective: The aim of this study was to develop the Japanese version of Primary Care Assessment Tool (JPCAT) and to examine the validity of this tool in the assessment of the quality of primary care from patient experience in J...

Background Japan’s stagnant economy has produced increasing income disparities, and the effect of poverty on health and health-care utilization is a significant issue. Co-payments could be a trade-off for patients when seeking medical care and limit health-care utilization. We sought primary care physicians’ experiences in dealing with financially...

Background: Maintaining a maternity care system is one of the biggest issues in Japan due to the decreasing number of obstetricians, especially in remote areas and islands. The aim of this qualitative study was to explore the challenges in women's health and maternity care in remote areas and islands for primary care physicians and obstetricians i...

Objective: The Great East Japan Earthquake and tsunami affected approximately 53 000 people in the city of Ishinomaki, Miyagi Prefecture. Approximately 30 000 people were relocated to temporary/rental housing. The remainder re-inhabited tsunami-affected houses, and their conditions were not known. As social isolation could affect physical and psyc...

The process of mixed methods data analysis has long been understudied and needs clear guidance for researchers. This review article honors Michael D. Fetters' pioneering work on mixed methods data analysis, building on his concepts of integration, joint displays, and metainferences. This review summarizes existing mixed methods data analysis discus...

Background The population of people living with dementia (PLwD) continues to grow in Japan where advance care planning (ACP) for PLwD is relatively new. Our aim was to evaluate the feasibility and cultural acceptability of a dementia‐specific ACP communication skills toolkit for Japanese primary care clinicians. Methods We delivered 13 training se...

Background Postpartum mental health care is a public health priority requiring interprofessional and interorganizational collaboration. Primary care physicians (PCPs) have the potential to play an essential role in facilitating access to health care and providing comprehensive and coordinated care for postpartum mental health problems. In Japan, ho...

Background Preconception care is not widespread in Japan and there is a pressing need to improve the practice. The present study assessed the knowledge and behavior of preconception care among women to seek effective intervention. Our research questions were: 1) How much do women know about preconception care? 2) How much are they practicing precon...

Background Multimorbidity management can be extremely challenging in patients with dementia. This study aimed to elucidate the approaches of primary care physicians in Japan and the United States (US) in managing multimorbidity for patients with dementia and discuss the challenges involved. Methods This qualitative study was conducted through one-...

Objectives Rural–urban healthcare disparities exist globally. Various countries have used a rurality index for evaluating the disparities. Although Japan has many remote islands and rural areas, no rurality index exists. This study aimed to develop and validate a Rurality Index for Japan (RIJ) for healthcare research. Design We employed a modified...

Introduction: Patients often refer to information on the Internet when selecting a medical institution, and some patients provide feedback on their experiences. In this study, we analyzed the content of patients' evaluations of medical institutions on Google. Methods: This study evaluated Google reviews and ratings of medical institutions in Shizuo...

Background Many women face a variety of barriers to seeing obstetricians and gynecologists (OB/GYNs). Primary care physicians (PCPs) in Japan are not well equipped to address and adequately handle women’s health issues. Hence, opportunities for women to consult PCPs about women’s health issues are often limited during busy outpatient encounters. It...

Background Guidelines worldwide recommend that physicians should not treat their family members. However, studies in the U.S. have shown that approximately 74–83% of physicians have experience of treating family members. Primary care physicians were more likely to have such experiences than other specialists. In Japan, physicians do not have any gu...

Background: Recently, work-life balance (WLB) has grown in popularity among medical professionals, and an increasing number of institutions are including WLB lectures into medical school curricula. In Japan, medical student lectures concerning WLB were given in at least 50% of universities. However, with these changes in social awareness, it is no...

Intergenerational theater activities have been recently employed in recreation for older adults. We held a series of four intergenerational theater workshops in two older adults’ care facilities in Japan and sought the experiences of older participants, younger participants, and the facility managers. With a qualitatively driven mixed-methods multi...

Introduction: This study explored the factors related to awareness of hope at the end of life among older adults who attend community-based preventive services for long-term care. Methods: Hope at the end of life was determined using a six-item questionnaire inquiring about topics such as "Medical hope when oral intake is not possible" and "Where t...

Background Although primary care (PC) is an indispensable part of the health system, measuring its quality is challenging. A recent measure of PC, Person-Centered Primary Care Measure (PCPCM), covers 11 important domains of PC and has been translated into 28 languages. This study aimed to develop a Japanese version of the PCPCM and assess its relia...

Background While dementia is a common problem in Japan and the US, primary care physicians' practices and perspectives about diagnosing dementia in these different healthcare systems are unknown. Methods Qualitative research was conducted in an ethnographic tradition using semi-structured interviews and thematic analysis in primary care settings a...

Background: To explore the perspectives and approaches of primary care physicians in Japan and the US on diagnosing dementia. Methods: Qualitative comparison conducted in ethnographic tradition using semi-structured interviews and thematic analysis. Primary care settings across Japan and in the Midwest State of Michigan, US. Participants were a tot...

Objectives Although frequent emergency department (ED) use is a global issue, little research has been conducted in a country like Japan where universal health insurance is available. The study aims to (1) document the proportion of ED visits that are by frequent users and (2) describe the differences in characteristics of frequent ED users and oth...

Introduction: To elucidate the issues surrounding adolescents' Internet use in social minority groups, this study investigated the current situation of Internet addiction among Brazilian students who live in A city in Japan. Methods: The participants were 342 local Brazilian students attending international schools. A cross-sectional study using a...

Objectives The rate of admissions for ambulatory care sensitive conditions (ACSCs) is a key outcome indicator for primary care, and patient experience (PX) is a crucial process indicator. Studies have reported higher rates of admission for ACSCs in rural areas than in urban areas. Whether there is an association between admissions for ACSCs and PX...

Background: The number of dementia patients in Japan is projected to reach seven million by 2025. While modern ethicists have largely reached the conclusion that full disclosure of dementia serves the best interest of patient, the implications of disclosure of a dementia diagnosis remains an underexplored area of research in Japan. The purpose of...

Introduction: We conducted 3 surveys to elucidate the current status of Women's Health (WH) training in Japanese General Practice Residency Programs, and the opinions that the residency program directors and learners have about the training. Methods: Three questionnaire surveys were conducted during Aug-Nov, 2015. Subjects of the surveys were resid...

Purpose In rural areas, the management of hospitalizations and emergency department (ED) visits is an important issue, and it is compounded by factors such as the long distance to secondary care facilities, funding difficulties in many rural medical institutions, and shortage of medical staff. While better patient experience (PX) has been shown to...

Background As research in family medicine covers varied topics, multiple methodologies such as qualitative research (QR) and mixed methods research (MMR) are crucial. However, we do not know about the difference in the proportion of QR or MMR between Japan, the UK and the US. This knowledge is needed to shape future research within countries with d...

Abstract Background Vaccination is an important element of health maintenance in family medicine. The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is highly recommended for the elderly, but its uptake is low in Japan. Primary care system remains under development and preventive services tend to be neglected in the Japanese medical practic...

Objectives Women and men might experience psychological distress differently during a disaster. This study investigated gender differences in the factors associated with psychological distress among working-age people 1 to 2 years after the Great East Japan Earthquake. Methods A cross-sectional household survey of victims who remained living in th...

[Purpose]This qualitative study tries to reveal the competencies of solo practice training in the islands. [Method]We conducted semi-structured interviews of seven physicians (6 men and 1 woman ) who have just started working at solo practice clinics in the islands of Okinawa Prefecture. They are 4th year graduates who have finished general traini...

Primary care is regarded as a setting that potentially mitigate patient health literacy (HL) related inequalities. However, there is a lack of evidence about influence of patient HL on the patients’ perception of quality of primary care. We aimed to examine the association between HL and patient experience of primary care attributes. We conducted a...

Item contents of the 14-item health literacy scale. (PDF)

Item contents of the Japanese version of Primary Care Assessment Tool. (PDF)

Background Patient experience and clinical quality, which are represented by preventive care measures such as cancer screening, are both widely used for the evaluation of primary care quality. The aim of this study was to examine the association between patient experience and cancer screening uptake among women in a Japanese population. Methods We...

Background Family medicine education-emerging countries face challenges in demonstrating a new program’s ability to train residents in womb-to-tomb care and resident ability to provide such care competently. We illustrate the experience of a new Japanese family medicine program with resident self-competency assessments. Methods In this longitudina...

Introduction: The rising poverty rate has spurred concerns regarding income-related disparities in medical-care utilization. This study attempted to investigate physicians'recognition of patients'refraining from medical care for financial reasons and the characteristics of physicians who made efforts to improve such situations. Methods: A mail surve...

Introduction: Patient-centric treatment is important in primary care, and one of the characteristics of this type of care is shared decision making (SDM) on treatment options between the patient and the doctor. However, no study has examined the circumstances of SDM practice in primary care in Japan. In this study, we investigated the proportion of...

Background: Studies from several countries demonstrate significant use of acupuncture and recent upward trends in use. Acupuncture is relatively common in Japan, but no previous research has evaluated its use in rural Japanese populations. Objective: To evaluate the use of acupuncture in rural Japanese populations. Design: By using a Japanese versi...

Family medicine is a linchpin of most successful health systems in the industrialized world, and is increasingly being seen as crucial in the current distressed financial climate. Japan has not had a robust family medicine infrastructure, but recently has begun to develop family medicine in several locations around the country. However, few of thes...

Background: Despite emerging national interest in training family physicians to improve access to medical services in health care shortage areas, empirical data on inpatient resident learning experiences in rural community settings has been lacking. This research sought to understand the breadth of diagnoses, patient demographics, and comorbidities...

Background: In contrast to many western nations where family medicine is a cornerstone of the primary care workforce, in Japan the specialty is still developing. A number of services within the bailiwick of family medicine have yet to be fully incorporated into Japanese family medicine training programs, especially those associated with sexual hea...

Objectives After bills to launch the Social Security and Tax Number System were enacted in 2013, health and political officials have considered the Healthcare Number System (the System). However, little is known about doctors' awareness and concerns about the System. This study aimed to measure how many doctors disagree with the System, examine the...

This study aimed to investigate the role of social factors, especially social support for sleep, among victims living at home around 1-2 years after the Great East Japan Earthquake and tsunami. A cross-sectional household survey was conducted between May and December 2012 (14-21 months after the disaster) in the Ishinomaki area, Japan. Univariate a...

Aims/IntroductionTo provide age- and sex-specific trends, age-standardized trends, and projections of diabetes prevalence through the year 2030 in the Japanese adult population.Materials and methodsIn this meta-regression analysis, we included 161,087 adults from six studies and nine national health surveys conducted between 1988 and 2011 in Japan....

The effectiveness of prophylactic antibiotics use for acute necrotizing pancreatitis has been explored and a number of systematic reviews have been published with conflicting results. The timing of antibiotics administration can be fundamental to their effectiveness, but thus far no reviews have focused on the timing of administration. A systematic...

We examined the association between social factors and sleep difficulties among the victims remaining at home in the Ishinomaki area after the Great East Japan Earthquake and Tsunami and identified potentially modifiable factors that may mitigate vulnerability to sleep difficulties during future traumatic events or disasters. A cross-sectional hous...

This study aimed at investigating whether impaired fasting glucose (IFG) is an independent risk factor for incident hypertension among middle-aged Japanese subjects with optimal blood pressure (OBP). This retrospective cohort study was conducted in 2943 non-diabetic and non-hypertensive subjects aged 40-64 years, who participated in a voluntary hea...

We examined how the prevalence of individuals diagnosed with diabetes differs by age and sex using the diagnostic criteria of fasting plasma glucose (FPG) and/or glycated haemoglobin (HbA1c) in a large Japanese population. We conducted a cross-sectional study using a dataset of 33,959 people (16,869 men and 17,090 women) without known diabetes who...

We investigated the value of persistent fasting hyperglycaemia as assessed by repeated elevated fasting plasma glucose in predicting the progression to diabetes. A retrospective cohort study was conducted from 1998 to 2006 inclusive among 7929 persons (37,742 person-years), with a mean age of 53.0 years at baseline. The cumulative incidence of diab...

Questionnaire. The questionnaire translated into English.

In order to evaluate the difference in quality of primary care provided by physicians between the types of medical institutions in Japan, we examined whether the physicians' comprehensive knowledge of their patients is perceived differently by the patients seen at clinics and hospitals. Patients with prescriptions for hypertensive drugs were approa...

Background: Malignant struma ovarii is a rare tumor, consisting of a struma ovarii with malignant change. Because of the rarity of the tumor, only a few reports with detailed data of thyroid function of the patient have been published. Case: Medical and surgical treatments were performed in a case of malignant struma ovarii with Graves' disease...