The present study developed the decisional balance scale for lung cancer patients to assess the benefits (pros) and the costs (cons) of out-patient chemotherapy. In addition, the decisional balance and the stages of change of out-patient chemotherapy were also examined. One hundred and five lung cancer patients receiving in-patient or out-patient chemotherapy were recruited to participate in this study. To develop the decisional balance scale of out-patient chemotherapy, we made 38 items of decisional-balance which included the items of pros and cons (19 each). The exploratory factor analysis and the analysis of variances (ANOVA) identified that the decisional balance scale of out-patient chemotherapy consisted of two factors (“pros” and “cons”) with each 10 items. It was confirmed that the decisional balance scale of out-patient chemotherapy had content validity, structural validity, factorial validity, and reliability. Furthermore, when the standard T scores of pros and cons at contemplation, preparation, and action stages were plotted, the intersection of pros and cons was located around the preparation stage. In conclusion, the decisional balance scale of out-patient chemotherapy was used as not only a valid instrument in introducing out-patient chemotherapy to patients, but also an educational material to encourage them to leave hospital.

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The presence or absence of roles in the family and QOL were studied, and their relationship was evaluated, in 58 old-old disabled (average age: 83.3 years) living at home. The subjects were divided into 35 subjects who had roles in the family (role present group) and 23 who had no particular role in the family (role absent group). BI score, TMIG index of competence and subjective health were significantly better in the role present group than in the role absent group. However, no significant difference was global life satisfaction or the sense of fulfillment. As a result of logistic regression analysis using the presence or absence of a household role as the dependent variable, a significant difference was observed in the odds ratio between the TMIG index of competence and subjective health. Therefore, TMIG index of competence and subjective health were found to be factors of the QOL related to household roles of old-old disabled at home. These observations suggest the importance for old-old to have household roles as much as possible even if they have disabilities, and the necessity of guidance for the entire family including the disabled elderly.

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The purpose of this study was to evaluate influences of a behavioral blood pressure (BP) control program (Kenkoutatsujin^TM) on BP and lifestyles in participants who received only first computer-tailored-advice out of two advices (one advice [OA]-group). Previous study has shown that the program led to sustained home BP reductions and lifestyle improvements in participants who received two advices (two advices [TA]-group). Since the results in OA-group were unknown, changes of clinic BPs and lifestyles in OA-group were compared with those in TA-group at follow-up survey. Follow-up-questionnaires were mailed for 693 participants 10-months after the program entry. Among 468 respondents (OA: n=248, response rate: 56.1%; TA: n=220, 87.6%), 232 participants were excluded because of antihypertensive-drug-therapy change (n=124) or incomplete-data (n=108). Finally, 236 subjects (OA: n=126, 62.3 yrs; TA: n=110, 61.9 yrs) were analyzed. Clinic BP reductions in both groups were significant (OA: –5.5/–4.2 mmHg; TA: –8.8/–6.5mmHg), and diastolic BP in TA-group was tended to reduce more than that in OA-group. Although lifestyle improvements were observed in both groups, they were superior in TA-group. The lifestyle improvements related to the clinic BP reductions in both groups. These results suggest that only one-tailored behavioral intervention may contribute to long-term lifestyle improvements and BP control.

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There is the hypothesis that maladaptive sleep hygiene and the dysfunctional beliefs and attitudes about sleep sustain the primary insomnia. But there were few studies on the relationships between insomnia and lifestyle or the cognition in Japan. The objective of this study was to verify the hypothesis by comparing sleep hygiene, the cognition and lifestyle practices of insomnia seminar group in a behavioral sleep hygiene education with control group. Compared to control group, insomnia seminar group reported poorer sleep efficiency and longer sleep onset latency, early morning awakening (time from awakening to rising). The total scores of lifestyle practices important to sleep of insomnia seminar group was low. But a more number of them limited to items of “using sleep aids” & “bedroom environment is bad”. Lifestyle practices important to sleep didn’t necessarily influence on insomnia. The total number of dysfunctional beliefs and attitudes about sleep were not significantly different between insomnia seminar group and control group. The hypothesis was supported limitedly from the results in this study. Sleep hygiene of insomniacs were individually varied. These results suggest that it is important to assess each person’s belief, attitudes and sleep hygiene, and give a tailored treatment for sleep improvement.

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