BACKGROUND: Individual-level social capital is an important determinant of older adults' long-term care needs; however, there is scant evidence regarding community-level social capital. Therefore, we investigated the association between community-level social capital and the prevalence of the need for long-term care among older adults. METHODS: Between January and February 2018, a cross-sectional survey was conducted among all older adults (n = 13,558) aged 65 to 74 years in a rural municipality in Japan (total population, n = 72,833). A self-reported questionnaire was used to identify community-level social capital, comprising civic participation, social cohesion, and reciprocity. A multilevel logistic regression analysis was performed to estimate the odds ratios of the need for long-term care and a decline in social activity competence as assessed by instrumental activities of daily living. For the analysis, the community levels were divided into 76 voting districts and adjusted for daily life, lifestyle, socioeconomic status, health conditions, and the three social capital subscale scores at the individual level. RESULTS: After adjusting for the covariates, we observed a tendency that a higher community level of reciprocity was associated with a lower prevalence of long-term care needs (OR: 0.86, 95% confidence interval: 0.75-1.00), whereas a high community level of social cohesion was associated with a significantly reduced decline in instrumental activities of daily living (OR per standard deviation increase: 0.87, 95% confidence interval: 0.79-0.96). No significant association was found with civic participation. Similarly, individual-level social capital was associated with the need for long-term care and decline in instrumental activities of daily living. CONCLUSIONS Our findings suggest that good community-level reciprocity or social cohesion as well as good individual social capital status may help prevent the need for long-term care among older adults.
Humans ; Aged ; Interpersonal Relations ; Activities of Daily Living ; Social Participation ; Social Capital ; Multilevel Analysis ; Cross-Sectional Studies ; Long-Term Care ; Japan/epidemiology* ; Social Support

BACKGROUND: Although nurses' workplace social capital for a healthy work environment has received considerable attention, few scales about nurses' workplace social capital are based on the attributes of clinical settings in Japan. This study aims to develop a Relational Workplace Social Capital Scale for Japanese Nurses (RWSCS-JN), which includes bonding, linking, and bridging social capital and assessing its reliability and validity. METHODS: We assessed its reliability and validity using questionnaire survey data collected from 309 nurses in the first survey and 105 nurses in the second survey in four hospitals in Japan. First, we determined the number of factors and items for the RWSCS-JN through the parallel and factor analyses after conducting the item analysis. Then, we confirmed the omega coefficients and intraclass correlation coefficients (ICC) of the RWSCS-JN. Finally, we examined the Pearson product-moment correlation coefficient between the RWSCS-JN score and other variables, including an existing measurement of workplace social capital, work engagement, and turnover intention. RESULTS: The newly developed RWSCS-JN contained 15 items, comprising three factors as follows: bonding social capital, linking social capital, and bridging social capital. The omega coefficient and the ICC of the RWSCS-JN were 0.90 and 0.85, respectively. The Pearson product-moment correlation coefficient between the RWSCS-JN and the existing scale of the workplace social capital was 0.88 (p < 0.01). Furthermore, the Pearson product-moment correlation coefficient between the RWSCS-JN and work engagement was 0.36 (p < 0.01) and that of the RWSCS-JN and turnover intention was - 0.40 (p < 0.01). CONCLUSIONS This study suggests that the RWSCS-JN could be sufficiently useful for a healthy work environment in a clinical setting.
Adult ; Female ; Humans ; Japan ; Male ; Middle Aged ; Nurses ; Social Capital ; Workplace ; standards

In countries with advanced health practices, it is important to note the importance of social capital and social support as social determinants in patient health as early as possible, while minimizing the constraints on self-management and reducing health inequalities. Beyond the individual, we offer mentoring and a social support system for individuals using community resources. We examined the growth of mentors and mentees through mentoring effectiveness and mentoring, and discussed the issues to be considered when applying such in the field. Ultimately, educators who are accustomed to 1:1 education or communicative group education should have the opportunity for recognition reconstruction.
Diabetes Mellitus ; Education ; Humans ; Mentors ; Self Care ; Social Capital ; Socioeconomic Factors

BACKGROUND: Ganz surgical hip dislocation via a posterior (Kocher-Langenbeck) approach is a popular procedure in the management of femoroacetabular impingement (FAI). We report the results of surgery performed through an anterolateral (Watson-Jones) approach in the management of anterolateral FAI. METHODS: Twenty-one hips in 20 patients (mean age at the time of operation, 17.3 years) were treated surgically using an anterolateral approach: 12 hips with Legg-Calvé-Perthes disease, three septic hips, three hips with avascular necrosis (combined with slipped capital femoral epiphysis [SCFE], femoral neck fracture, and developmental dislocation of the hip), two hips with epiphyseal dysplasia, and one hip with SCFE. All patients had anterolateral FAI. Surgical hip dislocation was performed in four hips with trochanteric osteotomy. Combined osteotomies were for neck lengthening in 11 hips, varus or valgus osteotomy in the proximal femur in four hips, and pelvic osteotomy in four hips. Clinical results were evaluated using a modified Harris hip score (mHHS). RESULTS: Range of hip flexion and abduction showed statistically significant improvement after surgery; however, the improvement in mean mHHS was not statistically significant. CONCLUSIONS: An anterolateral approach can be used as an alternative to a posterior approach in the management of anterolateral FAI with or without hip dislocation while safely preserving the blood supply to the femoral head and allowing simultaneous procedures in the proximal femur.
Dislocations ; Femoracetabular Impingement ; Femoral Neck Fractures ; Femur ; Head ; Hip Dislocation ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Neck ; Necrosis ; Osteotomy ; Slipped Capital Femoral Epiphyses

BACKGROUND: Prophylactic pinning of the uninvolved side after unilateral slipped capital femoral epiphysis (SCFE) is controversial. The alpha angle, a measurement of femoral head-neck aspherity, was proposed as a predictor of progression of contralateral SCFE with a treatment threshold of greater than 50.5°. The aim of this study was to evaluate its validity in our cohort of patients. METHODS: A retrospective review of a 10-year series of patients who presented with unilateral SCFE was conducted. Minimum follow-up duration to identify contralateral progression was 18 months. Age, sex, ethnicity, and endocrinopathies were noted. Alpha angle measurements of the unaffected hip were performed by two independent observers. The average values of measurements were used for analysis. Univariate and multivariate logistic regression analyses were performed to identify predictors of contralateral progression. A receiver operating characteristic (ROC) curve was generated. RESULTS: There were 43 patients with unilateral SCFE. Seven patients (16.3%) developed contralateral SCFE. There were 31 males (72.1%) and 12 females (27.9%). The mean duration from index surgery to contralateral fixation was 43.9 weeks (range, 16.2 to 77 weeks). The mean alpha angle was significantly higher in the patients with contralateral progression (mean, 50.7°; standard deviation [SD], 5.4°; range, 43.8° to 58.5°) than in the patients without progression (mean, 43.0°; SD, 4.2°; range, 33.0° to 52.5°; p < 0.001). The alpha angle was also identified as a statistically significant predictor of contralateral progression on multivariate analysis (p = 0.02). The intraclass correlation coefficient for interobserver reliability was moderately strong at 0.76 (95% confidence interval, 0.55 to 0.87). The area under the ROC curve was 0.88. The treatment threshold of 50.5° had a sensitivity of 0.43, specificity of 0.94, and number needed to treat (NNT) of 2.7. The ideal treatment threshold derived from the ROC curve was 49.0°, which had a sensitivity of 0.71, specificity of 0.89, and an NNT of 1.7. CONCLUSIONS: Alpha angle is a potential predictor of contralateral hip involvement in children with SCFE who may benefit from prophylactic hip fixation. Results from our series suggest a treatment threshold be 49.0°. However, given the limited sample size and moderately strong interobserver reliability, larger studies are needed to validate our findings.
Asian Continental Ancestry Group ; Child ; Cohort Studies ; Female ; Follow-Up Studies ; Hip ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Retrospective Studies ; ROC Curve ; Sample Size ; Sensitivity and Specificity ; Slipped Capital Femoral Epiphyses

OBJECTIVE: To determine the factors associated with unmet needs in immigrant patients complaining of abdominal pain, by analyzing those associated with the time from symptom onset to emergency room visit.METHODS: We retrospectively reviewed the medical records of immigrants with abdominal pain who visited a tertiary hospital emergency department from January to December 2016. The dependent variable was the time from symptom onset to emergency room visit. The independent variables were age, sex, vital signs, disposition, health insurance status, date of visit, time of visit, level of education, employment status, economic satisfaction, marital status, living with family, duration of residence, having a native spouse, and subjective proficiency in Korean. We analyzed the association of the dependent variable with each independent variable.RESULTS: In total, 102 immigrant patients with abdominal pain were enrolled in this study. The patients who had earlier visits had good subjective proficiency in Korean, high economic satisfaction, longer durations of residence, a tendency to have a native spouse, and a high employment rate. After linear regression analysis, the time from symptom onset to emergency room visit was negatively associated with employment (adjusted odds ratio, -13.67; 95% confidence interval, -23.25 to -4.09; P=0.006) and having a native spouse (adjusted odds ratio, -11.7; 95% confidence interval, -20.61 to -2.8; P=0.011).CONCLUSION: The factors influencing the time from symptom onset to emergency room visit in immigrant patients with abdominal pain are associated with social capital, which improves access to emergency care. Policies that improve immigrant access to emergency care should be considered.
Abdominal Pain ; Adult ; Education ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Emigrants and Immigrants ; Employment ; Health Services Needs and Demand ; Humans ; Insurance, Health ; Korea ; Linear Models ; Marital Status ; Medical Records ; Odds Ratio ; Retrospective Studies ; Social Capital ; Spouses ; Tertiary Care Centers ; Vital Signs

BACKGROUND: The aim of this study was to investigate whether generalized trust and/or social participation at an individual level have negative associations with unmet healthcare needs. METHODS: Door-to-door interviews were conducted by trained interviewers to collect information. The 8,800 study participants included 220 adults sampled systematically using the resident registration database from 40 sub-municipal-level administrative units in Korea. Unmet healthcare needs were measured subjectively by the following question: “During the past 12 months, was there ever a time when you felt that you needed healthcare (excluding dental care) but did not receive it?” The responses were classified as either “yes” or “no.” RESULTS: The adjusted odds ratios (ORs) for unmet healthcare needs based on one positive response, two positive responses, and three positive responses to the three items of generalized trust compared to no positive responses were 0.92 (95% confidence interval [CI], 0.77–1.09), 0.90 (95% CI, 0.74–1.09), and 0.73 (95% CI, 0.61–0.87), respectively. The adjusted ORs for unmet healthcare needs based on social participation only in informal organizations, only in formal organizations, and in both informal and formal organizations compared to no social participation were 0.83 (95% CI, 0.71–0.98), 0.97 (95% CI, 0.77–1.21), and 0.97 (95% CI, 0.82–1.15), respectively. The covariates included in the multiple logistic regression were sociodemographic variables (gender, age, marital status, educational level, occupation, food security, and administrative unit), self-rated health, and perceived stress. CONCLUSION: Therefore, generalized trust and social participation in informal organizations can decrease the incidence of unmet healthcare needs.
Adult ; Delivery of Health Care* ; Food Supply ; Humans ; Incidence ; Korea ; Logistic Models ; Marital Status ; Mortality* ; Occupations ; Odds Ratio ; Power (Psychology) ; Social Capital ; Social Participation*

PURPOSE: The aim of this study is to examine a path model on the relationship among social capital, physical activity and subjective health status in the community indwelling elderly. METHODS: The study was conducted utilizing the 2014 Seoul Survey, in the method of analyzing cross-sectional design and secondary data. Among 45,497 participants in total, the data of 4578 adults aged 65 or above was analyzed. Social capital was measured by social trust and social participation. Physical activity was measured by regular exercise. Additionally, a numerical rating scale was used to assess subjective health status. The data were analyzed using descriptive statistics, Pearson's correlation coefficients and path analysis. RESULTS: Social participation and physical activity showed a direct effect on subjective health status in community indwelling elderly while social trust and physical activity showed an indirect effect on their subjective health status. The hypothetical path model of community indwelling elderly's subjective health status was proved correct. CONCLUSION: Findings from this study indicate that health-promoting intervention for community indwelling elderly should consider social trust and participation.
Adult ; Aged ; Diagnostic Self Evaluation ; Humans ; Methods ; Motor Activity ; Seoul ; Social Capital ; Social Participation

PURPOSE: The purpose of this study was to identify the casual relationship between nurses' social capital, job engagement and nursing performance and to verify the goodness of fit between a hypothetical model and actual data in order to suggest the best model. METHODS: This survey was conducted with 250 nurses working in 3 general hospitals in Seoul. Data were collected from June 20 to July 29, 2016 and analyzed using SPSS/WIN 21.0 and AMOS 21.0. RESULTS: Nurses' social capital and job engagement were found to have no direct effect on increasing nursing performance. But, it was found that social capital and job engagement had indirect effects on nursing performance through mediating organizational citizenship behavior. Social capital had direct effects on increasing job engagement and indirect effects on organizational citizenship behavior. CONCLUSION: Results of this study indicate that nurse managers should concentrate efforts on increasing nurses's job engagement and preparing organization to increase social capital in order to improve nursing performance.
Hospitals, General ; Humans ; Negotiating* ; Nurse Administrators ; Nursing* ; Seoul ; Social Capital* ; Work Performance

PURPOSE: This study was conducted to examine the current status of transformational leadership behavior (TLB) and organizational citizenship behavior (OCB), and to investigate the mediating effect of social capital on the relationship between TLB and OCB in hospital nurses. METHODS: A cross-sectional descriptive study design was used with a convenience sample of 219 nurses from two university-affiliated teaching hospitals in South Korea. RESULTS: The survey instruments measured TLB, OCB, and social capital. Data were analyzed using t-tests, ANOVA, Scheffé's test, Baron and Kenny's regression method. The average level of TLB was 3.13 points, for OCB 3.64 points, and for social capital 3.24 points in social capital. Positive correlations were found between TLB, OCB, and social capital. Hospital nurses' social capital showed a significant mediating effect on the relationship between TLB and OCB. CONCLUSION: Findings indicate that TLB is a contributing factor to better OCB, and TLB can lead to improved OCB through social capital. Interventions to improve social capital of nurses in health-care organizations have important implications for OCB improvement.
Hospitals, Teaching ; Korea ; Leadership* ; Methods ; Negotiating* ; Social Capital*