The purpose of this study is to clarify the actual situation regarding adherence to an exercise regimen in individuals with type 2 diabetes, and to examine the psychosocial factors that influence this phenomenon. A self-recording questionnaire survey and the measurement of physical activity using an accelerometer were carried out for the patients who had been recommended to participate in exercise regimen. The number of steps walked and the “active physical activity” that the patients participated in the exercise regimen were evaluated as an index of adherence to an exercise regimen by making 131 people who excluded the people who didn't agree on exercise regimen the subject and the findings were then analyzed by a stepwise multiple-regression analysis.
The average number of steps walked, the active physical activity of about 3 METs or more that the subjects participated in the exercise regimen were as follows:8,817 steps/day, 18.7 METs×h/week, respectively. Self-efficacy for exercise was therefore found to be the factor which most greatly influenced adherence to an exercise regimen.
The number of steps walked and the active physical activity were found to be related to BMI and HbA_1c, therefore it's necessary to raise adherence to an exercise regimen in order to help patients to control their blood sugar levels. In order to raise patient adherence to exercise regimens, we utilized a pedometer, etc., while regarding specific exercise goals in regard to the amount of exercise in numerical targets, it is considered to be important to design exercise regimens according to the needs and abilities of each individual on a case by case basis.

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Objectives: To develop a “MITORI” Care Scale that evaluates nursing care for patients with end-stage cancer and their families and to examine its reliability and validity.
Methods: The original “MITORI” Care Scale was developed based on a descriptive study and a comprehensive review of the literature. A revised 49-item version was developed based an examination of the content validity of the original scale. Subsequently, the revised questionnaire was distributed to 562 registered nurses employed at 4 general hospitals in Japan.
Results: Exploratory factor analysis by principal factor analysis with promax rotation was conducted. The following five factors comprised of 22 items were finally extracted: “Care facilitating death without regret,” “Spiritual care,” “Assurance of palliative care,” “Supporting decision making with appropriate information,” and “Arrangement of available care.” A confirmatory factor analysis was conducted by analyzing covariance structures and the hypothesized statistical model was found to fit the actual data. The reliability of the scale was confirmed by a Cronbach's alpha internal consistency reliability coefficient of 0.91 (0.67-0.83 for subscales) and a test-retest reliability coefficient of 0.74. The criterion-related validity was confirmed by interventions using Family Support and Dying Care, the Scale of the Professional Autonomy in Nursing, and the Satisfaction Scale of Hospice Nurses in Providing End-of-Life Care. Furthermore, the construct validity was confirmed by the known-group technique.
Conclusion: The above findings indicate that the “MITORI” Care Scale is sufficiently valid to improve the quality of nursing care for patients with end-stage cancer and their families.

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Purpose: Metabolic syndrome (MS) has become one of the major health concerns of this century, and profiling MS based on life-style conditions could lead to the successful development of preventative programs useful for public health nurses and professionals. In order to achieve this, life-style profiles for characterizing MS were constructed using 16 health behavior items on life-style questionnaires obtained during routine physical examinations.
Methods: Tree-based models were employed to construct health behavior profiles on the 18,849 examinees who were at least 30 years of age at the time of their exam. The risk of MS among different behavioral profiles was evaluated using odd ratios obtained by logistic regression models. Predictive utilities were assessed by estimating prediction error based on cross-validation methods.
Results: “I often think I eat too much” emerged as a common risk factor throughout all profiles. In addition, “frequency of oral care,” “speed of eating,” and “exercise other than walking” appeared as important behavioral risk factors. Upon evaluation using the test data, it was shown that the possibility for application was high in men's profiles.
Conclusion: Exploratory data analysis using the tree-based model on life-style data obtained from routine physical examinations revealed several health behavior profiles. These profiles may provide many practical and potentially useful methods for developing preventive programs for MS.

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Aim: The purpose of this study was to characterize anxiety, depression and clinical profile of patients in light of their asbestos exposure.
Methods: Outpatients from the Asbestos Center at Hospital A who visited for their first medical examination of asbestos-related illnesses were surveyed. We examined the relationships between anxiety prior to doctor consultation, anxiety as a personality trait, depression, X-ray findings, asbestos-related symptoms(e.g., cough and chest pain), age, and period since first exposure to asbestos. Anxiety was assessed using State Trait Anxiety Inventory, and depression was assessed using Beck Depression Inventory.
Results: Our analysis of 138 outpatients revealed that more than half of the patients felt strong anxiety prior to doctor consultation. No significant correlation was observed between anxiety prior to doctor consultation and the period since first exposure to asbestos. Patients with asbestos-related symptoms were more anxious prior to doctor consultation and depressed. Patients with 'asbestos-related findings' exhibited significantly more frequent symptoms, more anxiety prior to doctor consultation, a more anxious personality, and more depression, compared to patients with no asbestos-related findings. There was no correlation between anxious personality and age, period since first exposure to asbestos, and asbestos-related symptoms.
Conclusion: More than half of the outpatients seemed to exhibit anxiety prior to doctor consultation. Anxiety, depression, and frequency of asbestos-related symptoms were worse in patients with 'asbestos-related findings' than in those with no asbestos-related findings. Our findings demonstrate the need for psychological support in people exposed to asbestos.

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