Miyae Yamakawa

Background: Recent advancements in digital health technologies have led to the accumulation of large volumes of unstructured text data, particularly in electronic health records. Given that nursing documentation frequently includes detailed descriptions of daily living activities and psychosocial contexts, existing medical natural language processing (NLP) tools may not be directly applicable without adaptation. Moreover, the integration of standardized nursing terminologies into NLP systems remains limited. Although NLP has the potential to support risk detection, information management, and care planning, its practical applications in nursing have not yet been systematically mapped. Objective: This scoping review aimed to map the practical applications of NLP in nursing practice, with a specific focus on real-world clinical use, particularly for assessment, documentation, and interventions, and to identify the study characteristics, application domains, outcomes, and challenges. Methods: Following the Joanna Briggs Institute methodology and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, a systematic search was conducted across PubMed, CINAHL, the Cochrane Library, Scopus, Embase, and Ichushi-Web in October 2023 and June 2025. The population-concept-context framework (population: nurses; concept: NLP applications; context: clinical settings) was used to guide study selection. Two independent reviewers screened 2889 unique records and reviewed the full texts of 72 studies. Data were descriptively synthesized and thematically classified. Results: Six studies met the inclusion criteria, indicating that empirically evaluated applications of NLP in real-world nursing practice remain limited. NLP applications were categorized into three domains: (1) text summarization and generation, (2) information extraction and classification, and (3) real-time detection and screening. NLP was applied across multiple stages of nursing practice, including handovers, assessment, care planning, continuity of care, and patient safety management. Notably, NLP was used as a form of augmented intelligence to complement, rather than replace, nurses’ clinical judgment and to support clinical decision-making. These findings also highlight a substantial gap between rapid technological advances and the limited implementation of NLP in real-world nursing practice. Conclusions: This review highlights the substantial gap between rapid technological advances and the limited implementation of NLP in real-world nursing practice. NLP may help reduce manual review workload, support early risk identification, and facilitate individualized care planning in selected nursing contexts. However, direct empirical evidence regarding its effects on nursing workflows, nurses’ clinical decision-making, and patient-level outcomes remains limited. Future research should prioritize real-world implementation studies and evaluate nurses’ acceptance, adoption barriers, workflow integration, and the influence of NLP on clinical decision-making.

Background: How nurses, occupational therapists, psychologists, and speech‐language therapists in Japan understand their respective roles and collaborate, particularly in the early stages of semantic variant primary progressive aphasia, has not been sufficiently investigated. Aims: To clarify the experiences and professional roles of healthcare providers supporting individuals with semantic variant primary progressive aphasia and their families during the disease's early stages. Methods & Procedures: A qualitative descriptive study using a content analysis approach was conducted. Semi‐structured interviews were conducted with ten healthcare professionals who had experience providing care to individuals with semantic variant primary progressive aphasia and their families. Interviews were audio‐recorded, transcribed verbatim, and analyzed inductively using qualitative content analysis. Data were collected in hospital‐based outpatient settings in Japan between October 2018 and April 2020. Outcomes & Results: Four main categories were identified: (1) empathic understanding of the challenges individuals with semantic variant primary progressive aphasia and their families face in comprehending the disease and the need for structured rehabilitation; (2) supporting daily routines and family communication through structured rehabilitation; (3) promoting emotional stability and continuity of daily living through early intervention; and (4) connecting professional expertise across disciplines to support individuals based on a shared understanding. Participants described the challenges families face in accepting the need for early intervention and emphasized the importance of multidisciplinary collaboration in addressing emotional, communicative, and functional difficulties. Conclusions & Implications: Care for individuals with semantic variant primary progressive aphasia requires early, structured rehabilitation embedded within a multidisciplinary framework. Clear role delineation and shared understanding among healthcare professionals are essential for effective support. Strengthening interprofessional collaboration and establishing accessible pathways for early support may help maintain daily functioning, reduce caregiver burden, and improve quality of life. WHAT THIS PAPER ADDS: What is already known on this subject Semantic variant primary progressive aphasia (svPPA) is a progressive neurodegenerative condition characterized by semantic impairments that significantly affect communication and daily functioning. Previous studies have highlighted the importance of early diagnosis and multidisciplinary involvement in supporting people with svPPA and their families. Research has also described the roles of individual professions in dementia care. Internationally, multidisciplinary team (MDT) involvement is advocated to address the diverse needs of people with young‐onset dementia, emphasizing age‐appropriate services and continuity of care. However, limited qualitative research has examined how healthcare professionals from different disciplines collaborate in the early stages of svPPA and how their roles are experienced in practice. What this study adds to the existing knowledge This study provides an in‐depth qualitative exploration of interprofessional experiences and roles in the early support of people with svPPA. It highlights how healthcare professionals from different disciplines perceive their responsibilities, collaborate across professional boundaries, and adapt their practices to meet the complex needs of individuals with svPPA and their families. The findings reveal both facilitators and challenges of interprofessional collaboration in early svPPA care, offering new insights into role coordination, communication, and shared decision‐making that have been underexplored in previous research. What are the clinical implications of this study? The findings underscore the importance of early and coordinated interprofessional collaboration in svPPA care. Clarifying professional roles and fostering effective communication among healthcare professionals may enhance continuity of care and support for individuals with svPPA and their families. The study suggests that nurses and allied health professionals play key roles in bridging disciplines and responding to evolving needs. These insights can inform the development of interprofessional education, service models, and clinical guidelines aimed at improving early support for people living with svPPA.

Aim: To evaluate the effectiveness of sleep monitoring, report feedback, and telephone‐based guidance regarding sleep hygiene and daytime activity for community‐dwelling older adults. Methods: We conducted a three‐arm randomized controlled trial among community‐dwelling adults in Japan. Participants were divided into three groups: (A) sleep report feedback and telephone‐based health guidance for 6 months; (B) sleep report feedback and telephone‐based health guidance for the first 3 months followed by sleep report feedback alone for the subsequent 3 months; and (C) sleep report feedback alone for 6 months. All groups used a sleep monitoring device. The Athens Insomnia Scale (AIS) score was the primary outcome. We analyzed time‐series data by comparing different groups before and after the intervention to determine factors influencing the AIS score. All significance levels were set at p < 0.05. Results: In total, 229 participants (80, 74, and 75 participants in groups A, B, and C, respectively) were randomized (men: 37.1%; mean age: 78.5 years; average AIS score: 6.5). Linear mixed model analysis revealed a significant group‐by‐time interaction for AIS scores ( p = 0.002). Both intervention groups showed significant within‐group improvements in AIS scores at 3 months compared with baseline, whereas the control group showed no significant change over time. In between‐group comparisons, Group B showed significantly lower AIS scores than the control group at 3 months. Conclusions: Combining sleep report feedback with telephone‐based health guidance may support improvement in subjective sleep status among community‐dwelling older adults. Trial Registration: Committee and registered in the UMIN Clinical Trials Registry (study number: 21249; date of first registration: December 15, 2021; receipt number: R000052743; https://center6.umin.ac.jp/cgi‐open‐bin/ctr_e/ctr_view.cgi?recptno=R000052743 )

Loneliness is an epidemic affecting mental health across all demographics. It is linked to mental disorders, such as anxiety and depression, and despair, highlighting a significant public health issue as persons feel more disconnected in a connected world. This study aims to investigate the relationship between loneliness, Alzheimer's disease and suicidal behaviour. This review was systematised in a dichotomous manner. Therefore, two systematic reviews were initially carried out following the PRISMA statement. The loneliness was understood as feeling lonely. One group searched for associations between loneliness and Alzheimer's disease and the other between loneliness and suicidal behaviour, with a consecutive meta‐analysis. After that, it was searched for between the two groups to seek loneliness, such as an interface in meta‐analytic factor analysis. Depression is the most studied and cited factor associated with loneliness as a link between Alzheimer's disease and suicide. Loneliness demonstrated association with Alzheimer's disease (OR = 1.89, 95% CI 1.57–2.28; p < 0.001); suicidal ideation (OR = 2.17, 95% CI 1.88–2.51; p < 0.001); suicidal planning (OR = 2.36, 95% CI 1.91–2.92; p < 0.001); suicide attempt (OR = 2.54, 95% CI 2.13–3.04; p < 0.001); and suicide (OR = 4.9, 95% CI 4.4–5.5; p < 0.001). Entrapment, hopelessness, insomnia and stress demonstrated significative correlation ( r > 0.40; p < 0.001) with loneliness in the interface between AD and suicidal behaviour. Loneliness has been identified as a comorbid factor between AD and suicide. To prevent both AD and suicide, it is essential to monitor levels of stress, insomnia, feelings of entrapment and hopelessness. The triad of loneliness, hopelessness and insomnia seems to represent the greatest risk profile.

Background: Sleep quality is crucial for maintaining and enhancing health and quality of life in older adults. However, the specific components of sleep‐related lifestyle advice associated with improved sleep quality remain unclear. This exploratory study aimed to describe the themes of personalised health guidance provided to community‐dwelling older adults by targeting those whose scores on the Athens Insomnia Scale (AIS), a validated self‐reported measure of insomnia severity, improved after an intervention that combined sleep monitoring and personalised health guidance. Methods: In a 3‐month intervention, 12 trained healthcare professionals (including nurses and public health nurses) delivered individualized health guidance using sleep data obtained from a non‐wearable actigraphy device, the Active Sleep Analyser. Among them, 11 provided guidance to the participants whose data were included in the present analysis. Of the 168 older adults who received the intervention, the data from 162 participants with complete AIS scores were analyzed. From this group, 57 individuals who displayed improvements in their AIS severity classification over a 3‐month period were selected for qualitative analysis. The guidance sessions were recorded, transcribed verbatim, and analyzed using an inductive content analysis approach. Results: The analysis revealed seven major categories comprising 18 sub‐categories. The categories were: (1) Praise for improvements in sleep quality and behavioural change efforts; (2) evaluation and continuous support for behaviour change; (3) establishing appropriate napping habits; (4) developing a healthy daily routine and rhythm; (5) establishing appropriate sleep habits; (6) addressing factors affecting sleep quality; and (7) appropriate medical advice and recommendations to consult physicians. Conclusions: This exploratory study described the themes observed in the personalized health guidance provided to older adults who showed improvements in AIS scores. These findings provide descriptive insights and may inform the development of future interventions or hypothesis‐driven studies to support sleep health among community‐dwelling older adults.

Background: Social isolation and loneliness are significant risk factors for poor mental health in older adults, particularly those living alone with cognitive impairment. Socially assistive robots (SARs) offer a promising approach to enhance social connection and emotional well‐being in this population. This study aimed to examine the feasibility, acceptability and potential psychosocial impact of a 16‐week, home‐based use of a conversational SAR in cognitively impaired older adults living alone. Methods: This was a single‐arm, exploratory feasibility study involving home installation of a humanoid conversational robot (RoBoHoN) for 16 weeks. Usability was assessed with the System Usability Scale (SUS). Psychosocial outcomes, including loneliness (UCLA‐LS3) and depressive symptoms (GDS‐15), were measured pre‐ and post‐intervention. Semi‐structured interviews were conducted and analysed using hybrid content analysis to explore user experiences. Results: A total of 11 participants were enrolled, including individuals with mild cognitive impairment, mild dementia and late‐onset psychosis; nine completed the study. The mean age was 81.9 years, with an age range of 71–89 years. The mean SUS score was 81.7, indicating high usability even among cognitively impaired users. Small‐to‐moderate effect sizes were observed for reductions in loneliness and depressive symptoms (UCLA‐LS3: r = 0.40; GDS‐15: r = 0.64), although not statistically significant. Qualitative findings highlighted perceived companionship and increased opportunities to speak, while also noting limitations such as poor conversational depth, delayed responses and technical issues like battery depletion or sensitivity to background noise. Conclusions: The 16‐week home‐based use of a conversational robot was feasible and well accepted by older adults with cognitive impairment living alone. Although preliminary, findings suggest potential psychosocial benefits of SARs in this population. These results support the rationale for conducting a controlled trial targeting loneliness and depression in cognitively impaired, socially isolated older adults.

Background Although excessive alcohol consumption is a critical factor for non-communicable diseases, its clinical relevance to chronic kidney disease is controversial. Methods This retrospective cohort study, including 80,765 men and 88,507 women aged 40–74 years who underwent annual health checkups in Japan between April 2012 and March 2017, assessed a dose-dependent association between alcohol consumption (rare, occasional, and daily drinkers with ≤ 19, 20–39, 40–59, and ≥ 60 g/day) and incidence of ≥ 30% decline in estimated glomerular filtration rate (eGFR), eGFR < 60 ml/min/1.73 m² and presence of proteinuria (dipstick urinary protein ≥ 1 +), using Cox proportional hazards models adjusted for clinically relevant factors. Results The incidence of ≥ 30% eGFR decline was observed in 1231 (1.5%) men and 1291 (1.5%) women during the median observation period of 2.8 and 2.9 years, respectively. In men, daily drinkers consuming ≥ 40 g/day of ethanol were at significantly high risk for ≥ 30% eGFR decline (adjusted hazard ratio [95% confidence interval] of rare, occasional, and daily drinkers with ≤ 19, 20–39, 40–59, and ≥ 60 g/day: 1.00 [reference], 1.05 [0.87, 1.27], 0.99 [0.80, 1.21], 1.05 [0.88, 1.26], 1.23 [1.01, 1.51], 1.61 [1.22, 2.11], respectively). Similar dose-dependent associations with incidence of eGFR < 60 ml/min/1.73 m² and proteinuria were observed in men. Contrary to men, alcohol consumption was not associated with eGFR decline and proteinuria in women. Conclusion Men with alcohol consumption ≥ 40 g/day were at a high risk of eGFR decline and development of proteinuria. Graphical abstract