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Biomedical subjects

Yoriko Kozuki

Publications and source records attributed to Yoriko Kozuki.

7 recordsLinked to original sources

Visual-feedback therapy for antipsychotic medication adherence.

This pilot study aimed to examine the effectiveness of visual-feedback therapy for individuals with psychotic disorders. Visual-feedback therapy combines structured psychodynamic therapy and visual feedback achieved via an electronic monitoring medication cap to increase insight about medication behaviours. Thirty subjects were randomly assigned either to visual feedback or to a supportive counselling group. Medication adherence was measured by both electronic monitoring and blood plasma drug concentration levels. The results showed that, at the end of the 3-month, intervention (bimonthly sessions), adherence rates of the visual-feedback group slightly increased, but declined during the course of the study for the supportive counselling control group (P=0.026).

Adult↗

Relational experiences of partnered Japanese immigrant women with affect disorders.

AIM: This paper reports the findings of a study that explored characteristics of relationships of Japanese immigrant women partnered both intraculturally and interculturally, and analysed the role of Japanese culture in these relationships. BACKGROUND: Immigration can cause shifts in interpersonal structures with partners. When there are large discrepancies in gender roles and communication styles between the original and host cultures, the psychological impact on both partners may be significant. However, currently no empirical data are available to support this assumption. METHODS: Ten cases selected from the 68 medical records of Japanese-speaking women seen at a mental health clinic from September 2001 to September 2004 were analysed. All of the 10 women met DSM IV-TR criteria of major depressive disorder and were taking antidepressants. Half of the 10 women were in intimate intercultural partnered relationships and the remainder of the matched cases were in intracultural relationships at the time of treatment. The two cohorts were matched in age (36.2 and 43.2 years), length of stay in the United States of America (12 and 16.2 years), and length of treatment (1.2 and 1 years). The length of time of the sample in individual psychodynamic psychotherapy ranged from 20 to 317 hours, depending on the intensity of therapy. FINDINGS: Inductive data analysis revealed two themes: (1) Lack of awareness of differences in culturally bound communication by Japanese women in intercultural partnerships; (2) Lack of individuality in Japanese women in intracultural partnerships. Neither group appeared to consider relational aspects of partnership, or to make efforts to improve direct communication with their partners. CONCLUSION: The influence of Japanese culture on gender role and communication styles functions contrary to the mainstream Western culture of the United States of America. In the future, interpersonal elements of cultural differences between host and original cultures in immigration should be considered in research related to immigrants' mental health. This approach should lead to effective interventions to facilitate mental health among immigrants, and regardless of purposes of immigration or length of stay in a psychosocially foreign environment.

Adult↗

Visual feedback therapy to enhance medication adherence in psychosis.

Adherence to antipsychotic medications is key to enhancing maximum responses to medication and to decreasing relapse rates among those with psychotic disorders. Visual feedback therapy used electronic monitoring to provide visual feedback of daily medication-taking behaviors, combined with supportive counseling and education components. Twenty-three participants with DSM-IV diagnoses of psychotic disorders were recruited from community and inpatient settings. No statistical significance was found for intervention weekly for 1 month, followed by monthly for 2 months, although a majority of participants either maintained or increased adherence rates at 1 month. Additional findings included associations between low insight and low adherence and descriptive data on medication adherence behaviors.

Adult↗

Adherence and nonadherence to antipsychotic medications.

The aims of this study were to identify dimensions of reasons for adherence and nonadherence to antipsychotic medications, and their associations with clinical and demographic profiles. A total number of 106 participants with DSM-IV psychosis spectrum disorders from two larger studies in inpatient and community settings participated. The Rating of Medication Influences (ROMI) Scale was used to measure subjective reasons for adherence and nonadherence. A series of multiple regression analyses found that mood symptom scores on the Positive and Negative Syndrome Scale (PANSS) predicted most dimensions of reasons for adherence and nonadherence. Higher mood scores were associated with positive affinity for medications and positive relationship with clinicians. Lower mood scores predicted four out of five reasons for nonadherence. Adherence and nonadherence behaviors were determined by different variables and were not mirror opposites.

Adult↗

Cultural incommensurability in psychodynamic psychotherapy in Western and Japanese traditions.

PURPOSE: To examine cultural incommensurability between clients of Japanese ancestry and Western therapists. DESIGN: Aggregated case-study method was used to analyze psychotherapy cases of Japanese individuals seen by Western therapists. Eight cases were selected for this study from a private practice client pool. FINDINGS: Themes were: (a) only observable data were valued for diagnosis and treatment; (b) cultural stereotypes hampered treatment; (c) individuation and separation occurred within a social web of norms in Japanese culture; (d) key concepts in mental health such as "death and dying" and "rape" were interpreted by clients within a Japanese cultural framework, resulting in unique psychological reactions and behaviors, which had not been recognized by Western therapists; (e) psychological effects of immigration were minimized or ignored by Western therapists; (f) culturally unfamiliar behaviors were "pathologized" by Western therapists; and (g) Western therapists showed ethnocentric biases regarding the effects of immigration. CONCLUSIONS: Various forms of misunderstanding and culturally ignorant practices were found in the treatment of eight Japanese clients by these Western therapists. These ineffective and often harmful practices were unrecognized by the Western therapists.

Adolescent↗

Lack of awareness and nonadherence in schizophrenia.

This cross-sectional study examines whether lack of awareness of symptoms is a predictor for nonadherence. The study consecutively recruited 134 participants with Diagnostic and Statistical Manual of Mental Disorders, 4th edition, diagnoses of schizophrenia spectrum disorders at acute psychiatric units. Outcome was measured by a combination of self-reports, utilizing the Rating on Medication Influences and medical records. The univariate analysis showed that homelessness was a predictor for nonadherence (p = .03). The subsequent logistic regression showed that the multidimension symptom lack of awareness score was significantly associated with nonadherence to psychotropic medications (odds ratio = 0.59, 95% Confidence Interval = 0.35, 0.96). Other clinical and demographic variables as well as subjective responses were not significant predictors of nonadherence.

Adolescent↗

Theoretical applications of smoking cessation interventions to individuals with medical conditions: women's initiative for nonsmoking (WINS)-part III.

This paper reviews the Theory of Self-Efficacy, Transtheoretical Model of Readiness for Change, and Theory of Addictions to provide a basis for smoking cessation, and explores how these theories have been used to guide clinical research and clinical interventions. Selected randomized controlled trials of the past ten years are reviewed for demonstrated efficacy, integration of theory into the design of the interventions, and how theories guide analysis. Results show that surprisingly little effort has been put forth to examine and develop these theories within the context of clinical interventions, despite the claims of importance. For example, the relationship between stages of readiness of change and smoking cessation outcome has not been examined. Despite the complexity of smoking behaviors (quitting, relapsing, maintaining, occasional smoking and so on), the concept of self-efficacy was mostly measured on single occasions over the course of most studies reviewed; multiple measurements of concepts were not utilized in the randomized controlled trials. Taking into account the gaps between theory and application, theory driven nursing strategies are offered.

Cardiovascular Diseases↗