Purpose: The purpose of this study was to acquire integrated views from previous studies on what interventions by rehabilitation specialists have led to the reduction of the care burden for stroke survivors' families.Method: Reported randomized controlled trials concerning interventions for the care burden of stroke survivors' families by rehabilitation specialists were extracted from two electronic databases, and their content was assessed by a systematic review.Results: Among the 11 analyzed studies, no studies focused on the stroke survivors' families. Studies reporting a reduction in the care burden were those comparing the presence of botulinum therapy and those comparing occupational therapy and non-intervention.There were no significant differences in the care burden for stroke survivors' families between the interventions by rehabilitation specialists and standard rehabilitation.Conclusion: Interventions for stroke survivor's families by rehabilitation specialists do not reduce the care burden in comparison with standard care.

Purpose: To clarify intervention methods used by medical professionals in clinical situations and their effects on the health literacy of patients.Method: Reports on randomized controlled trials for the health literacy of patients were collected from the electronic database. The reports were then evaluated using qualitative systematic reviews conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement.Result: On examination of the effects by intervention methods, we found that many reports concluded an improvement in health literacy by patients by "only the distribution of handouts". Moreover, many reports also noted improved "adherence for health behavior" by patients following the "distribution of handouts and explanation by medical professionals". Furthermore, improved "health literacy" by "one-way intervention from medical professionals to patients" and "two-way intervention by both medical professionals and patients" was reported.Conclusion: Based on this study, it may be possible to provide information considering individuality when the medical professional provides an explanation to the patient in addition to giving handouts. Improved disorder comprehension and self-management skills are expected when the medical professional appropriately confirms the patient's comprehension level.

Introduction: In this study, we examined the behaviors by clinical therapists necessary for shared decision-making (SDM) in the rehabilitation area.Methods: Five physical and occupational therapists participated in a focus group interview conducted using semi-structured interview protocols. The interview questions were: i) what skills do therapists need to involve patients in clinical decisions; ii) what would constitute a successful shared decision between a patient and a therapist; iii) what stages could be identified and observed in clinical decisions; and iv) are there any other elements necessary for SDM. From transcripts of the recorded interviews, qualitative thematic analysis was used to extract the behaviors in clinical therapists necessary for SDM in the rehabilitation area.Results: As a result of the analysis, 16 elements were extracted as behaviors by clinical therapists necessary for SDM in the rehabilitation area. The extracted elements were classified into two categories: providing information to patients (disorder, patient's role, options, purpose of rehabilitation, incorporation of patient opinion, and satisfactory explanation) and gathering information from patients (knowledge, preference, expectation, way of life, hope, understanding, question, opinion on recommendation, disagreement, mutual agreement).Conclusion: In this study, the elements based on the decision-making situation in the rehabilitation area were extracted from the behaviors by clinical therapists necessary for SDM.

Purpose: It is unclear whether high-definition (HD) imaging improves visibility and diagnostic ability in early gastric cancer (EGC) compared with standard-definition (SD) imaging. We aimed to compare the diagnostic performance and visibility scores of HD and SD ultraslim endoscopes in EGC. Materials and Methods: We used HD and SD ultraslim endoscopes to obtain 60 images with similar compositions of gastric environments. Of the 60 images, 30 showed EGC (15 images for each modality) and 30 showed no EGC (15 images for each modality). Seventeen endoscopists evaluated the presence and location of the lesions in each image. Diagnostic ability was compared between modalities. The color difference between a lesion and the surrounding mucosa (ΔE) was measured and compared between the modalities. Results: The ability of HD to detect EGC was significantly higher than that of SD (accuracy:80.8% vs. 71.6%, P=0.017; sensitivity: 94.9% vs. 76.5%, P<0.001; positive predictive value, 76.2% vs. 55.3%, P<0.001; and negative predictive value (NPV), 94.1% vs. 73.5%, P<0.001).The ability of HD to determine the horizontal extent of EGC was significantly higher than that of SD (accuracy: 71.0% vs. 57.8%, P=0.004; sensitivity: 75.3% vs. 49.0%, P<0.001; NPV, 72.9% vs. 55.9%, P<0.001; and area under the curve: 0.891 vs. 0.631, P=0.038). The mean ΔE was significantly higher for HD than for SD (10.3 vs. 5.9, P=0.011). Conclusions The HD ultraslim endoscope showed a higher diagnostic performance in EGC than the SD endoscope because it provided good color contrast.