[in Japanese]

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Abstract
　　　The physician’s work style reform aims at preventing ill health such as cardiovascular diseases caused by persisting inadequate sleep duration among Japanese physicians, In this study, we focus on the association between short sleep duration of less than 6 hours and weekly work hours of 60 hours or longer, shortest between-work interval of less than 9 hours, monthly voluntary study exceeding 10 hours, and high burden of family care.
　　　Data analyzed here were obtained by anonymous self-administered questionnaire survey of fulltime physicians working in 76 Saiseikai hospitals throughout Japan in 2021. A total of 1,468 physicians answered the questionnaire, covering 35% of all physicians, and data of 1,054 physicians, 803 males and 251 females, without missing information were analyzed. A series of logistic regression analysis were performed with the short sleep duration as dependent variable and work hours, between-work interval, voluntary study and family care as independent variables.
　　　Among male physicians, short sleep duration showed significant associations with work hours for both age 20-39 and 40+, and a significant association with high burden of family care for age 40+ but not for age 20-39. Among female physicians, short sleep duration showed a significant association of odds ratio of 4.7 with voluntary study for age 20-39, a significant association of odds ratio of 7.8 with high burden of family care for age 20-39, but did not show any significant association with work hours for both age 20-39 and 40+.
　　　It is noteworthy that a strong association was identified between short sleep duration and high burden of family care among female physicians of age 20-39. Female physicians as a whole receive better considerations for high burden of family care as compared to male physicians, but those female physicians missing such considerations are suffering short sleep duration.
　　　These female physicians should be the target for further countermeasures. Also, the association between short sleep duration and long hours of voluntary study warrants further considerations.

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　　　To ensure the quality of medical care provided by hospitals, it is necessary to maintain and improve the level of job satisfaction among physicians. In this study, we analyzed the relationship between physicians' job satisfaction and various factors of their working styles using data from the 2nd Physician Survey of the "Study on the Actual Conditions and Future Ideal Working Styles of Doctors at Saiseikai Hospitals " in 2021. The survey was a self-administered, anonymous questionnaire survey completed by 1,468 full-time physicians at 76 hospitals, with a response rate of 35.0%.
　　　A CART regression tree was created using physicians' overall satisfaction with their workplace as the objective variable and almost all variables other than satisfaction as explanatory variables; sex, age, number of beds and physicians at the hospital, and various factors related to the way physicians work. The results showed that physician fatigue, physicians' own physical and mental anxiety, sleepiness, and physicians' high stress levels had a significant impact on satisfaction, while objectively ascertainable indicators such as the number of physicians and beds at the hospital, work hours and work style, commuting time, sleep duration, and exercise habits had little direct impact.
　　　To increase the overall satisfaction of the Saiseikai physicians with their workplaces, attention should first be paid to reducing the accumulation of fatigue among physicians. Furthermore, assistance may be needed for physicians who have high levels of anxiety about their own physical and mental health and for those with a heavy burden of caring for their families.

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　　　Saiseikai was one of the first welfare facilities to respond to disasters by establishing and operating the Saiseikai DCAT. The purpose of this survey is to clarify the issues that need to be addressed in the event of a disaster by conducting interviews at both the receiving facility and the dispatching facility.
　　　It is necessary to have an organization in place to request specific support in the event of a disaster. The importance of taking initiatives on a daily basis in anticipation of a disaster was suggested. On the other hand, in terms of establishing a dispatch system, many welfare facilities are in a state where they do not have enough staff, and the difficulty in coordinating on-site shifts when it comes to dispatching staff is a challenge. It will first be necessary to establish a training program and disseminate understanding of DCAT.
　　　Currently, welfare facilities are required to formulate a plan for business continuity and conduct training and drills as part of their response in the event of a disaster or infectious disease outbreak. Since receiving and dispatching aid during a disaster are two sides of the same coin, it is necessary to examine facility operations with this aspect in mind. In our research, we will continue to focus on welfare facilities and communities in times of disaster from multiple perspectives and contribute to the establishment of a universal support and dispatch system.

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Staff members of facilities for severely mentally and physically disabled children (persons) often encounter difficulties in understanding the reactions and signs issued by disabled inpatients who do not have linguistic ability to communicate with others. The aim of this study was to examine the factors affecting this difficulties in nonlinguistic communications. The research method was a qualitative and descriptive analysis of what was discussed during the research meeting with 11 staff workers of facilities for severely disabled inpatients. As a result, five categories were identified as factors affecting staff members to understand nonverbal reactions and signs of disabled; (1) difference in staff’s personal view for practice, (2) difference in perception of inpatients, (3) difference in experience of practice, (4) insufficient information exchange about inpatients between staff members, and (5) insufficient daily life experience on the side of inpatients. Two additional categories were identified with regard to the situations when the reactions and signs were issued; (6) appearance and change of inpatients and (7) staff’s judgment in capturing the reactions and signs of inpatients. A total of seven categories, 11 subcategories, and 36 codes were extracted accordingly. The most important factor that caused the difficulty to understand nonverbal reactions and signs was (1) difference in staff’s personal view for practice. It was further found that this staff’s personal view for practice was related to staff’s values as healthcare professional as well as staff’s values as a person. In addition, (4) insufficient information exchange about inpatients between staff members, and (5) insufficient daily life experience on the side of inpatients were found to affect directly (6) appearance and changes of inpatients and (7) staff’s judgment in capturing the reactions and signs of inpatients.

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[in Japanese]

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Saiseikai Research Institute Bulletin
Vol.2
June 30th, 2022

Publisher
Social Welfare Organization Saiseikai Imperial Gift Foundation
Director
Shigeru Sumitani

Editor
Saiseikai Research Institute of Health Care and Welfare

Mita-Kokusai Bld.21st floor, 1-4-28, Mita, Minato, Tokyo,
108-0073, Japan

TEL: +81-3-3454-3315
FAX: +81-3-3454-5022
URL: http://soken.saiseikai.or.jp/

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