ABSTRACT
Objective: We aimed to clarify factors associated with the ability to seek help among older male caregivers who care for women with dementia in their families.Patients and Methods: This information will inform strategies to support their continued provision of long-term care. Participants were 364 male caregivers recruited from three places: The study period was 2017–2018. We obtained ethical approval for this study from the relevant ethics committee.Results: The ability to seek help for care problems among male caregivers was normally distributed. We found that more than 90% of older male caregivers did not actively seek help to resolve care problems, suggesting that older male caregivers had problems with long-term care. In the high score group, health status and the number of emotional support persons in the household were significantly and somewhat strongly positively correlated. The low score group showed a significant and rather weak positive correlation between economic status and health status, and the number of emotional supporters inside and outside the household.Positive correlations for the high score group were self-esteem and depressive symptoms, and self-esteem and resources. Positive correlations for the low score group were self-esteem and depressive symptoms, self-esteem and resources, and resources and depressive symptoms.Conclusion: Male caregivers are more likely to seek help if they are employed or play a role in their community. Nurses also need to support male caregivers with positive words and praise to help them use available support and resources and continue to provide long-term care. It is important for healthcare professionals to observe whether a caregiver presents with depressive symptoms or has long-term care problems because older male caregivers do not seek help. Collaboration between caregivers and medical, long-term care, and welfare professionals is necessary. Direct and timely intervention is needed.
ABSTRACT
The purpose of this study was to evaluate the stress accompanying behavioral and psychological symptoms of dementia (BPSD) and to validate the care that brings eustress through physical and emotional interventions. The participants were 57 elderly people with BPSD who used or lived in long-term care facilities, group homes, small-scale multifunctional home care services, and community-based specified facilities in prefecture X. The study included a 2-week control period and a 12-week intervention period in which square-stepping exercise (SSE) was introduced and the validation method was used for communication. Results showed that stress levels were higher when BPSD appeared. After SSE, amylase activity levels decreased in 70% of the participants, although the decrease was not statistically significant, and facial expression significantly improved in Face Scale (FS) assessment. Also, after validation communication, amylase activity levels showed a significant decrease and facial expression significantly improved in the FS assessment. Even though most of the participants in this study were elderly people with moderate dementia, SSE appeared effective for enjoying physical activity and making friends, and validation can be expected to have the effect of sharing time and relieving stress.
ABSTRACT
It has been reported that 30% of deaths related to the Kumamoto Earthquakes were among those who had spent nights in the car. Spending nights in the car imposes heavy mental and physical burden, but it has been examined in only a few studies. At 1 year after the Kumamoto Earthquakes, this study examined the factors affecting the mental health of 460 disaster-affected workers at 13 companies who stayed in the car. It was found that 181 workers (72.7%) had spent nights in the car. They had significantly higher scores on the Athene Insomnia Scale, revised Impact of Event Scale (IES-R), and General Health Questionnaire (GHQ) 28 compared with workers who had not stayed overnight in the car. Multiple regression analysis showed that “physical functioning”, “social functioning”, “anxiety and insomnia”, and “staying in the car” were factors affecting the IES-R score, while “vitality”, “avoidance symptoms”, “staying in the car”, and “subjective symptoms” were factors affecting the GHQ 28 score. Mental burden on workers in a natural disaster are imposed in addition to accumulated work burden. Given that mental burden may not ease over a prolonged period, there appears to be a substantial need to urgently discuss how assistance measures should be provided.
ABSTRACT
The aim of this study was to clarify the current status of depression among healthy community-dwelling elderly people and to examine the association between depression and their sense of purpose in life. A self-administered questionnaire survey was conducted with 213 elderly people who attended a public lecture at University A. The outcome measures were the Geriatric Depression Scale (GDS), the K-1 Scale for the Feeling That Life Is Worth Living Among the Aged (Ikigai Scale), the Social Support Scale for the Elderly (Social Support Scale), and a basic checklist (Frailty Scale). Using a cut-off of 4/5 points on the GDS, respondents were divided into a non-depressive group (≤ 4 points) and a depressive group (≥ 5 points). Each variable was compared between the two groups. Multiple regression analysis was performed to examine factors associated with depression. Among the 213 people who received the survey, 196 responded (response rate: 92.0%) and 185 provided valid responses after excluding those with missing data (valid response rate: 86.9%). Of these 185 respondents, 80 were classified into the non-depressive group (35 men, 45 women) and 52 into the depressive group (14 men, 38 women), which showed a significant sex difference. Mean age was 73.2 (SD 6.9) years in the non-depressive group and 76.1 (SD 7.74) years in the depressive group, which also showed a significant difference. The Ikigai Scale score was significantly higher in the non-depressive group compared with the depressive group. The Ikigai subscale scores for “self-realization and will”, “sense of life fulfillment”, “will to live”, and “sense of existence” were significantly higher in the non-depressive group. In the multiple regression analysis, factors associated with depression were sense of life fulfillment (β=－0.36), health status (β= 0.24), will to live (β=－0.17), age (β= 0.24), negative support (β=0.18), and healthy habits (β=0.12). These results suggest that depression is associated with self-realization, sense of life fulfillment, will to live, and sense of existence, indicating the importance of activities that create a sense of purpose in life for preventing depression in the community-dwelling elderly people.
ABSTRACT
It has been reported that a comprehensive community support center cannot maintain boundaries between particular specialties (ie, public health nurses, social workers, and the chief care manager), resulting in excessive workload, staff shortages, and resignations. Nurses are beginning to acknowledge poor interprofessional interactions among themselves and are now concerned with improving nursing practice. In this study, we aimed to clearly specify the specialties of nurses in order to obtain relevant basic data for establishing an educational training system for community health nurses. We conducted text mining analysis using KH Coder open source software by targeting 8 community health nurses with over 3 years of experience in Prefecture A. The following 5 clusters of specialties were extracted: “Ability to provide consultation, maintain good relationships, and make good decisions”, “Good knowledge of medical care in general, care of the elderly with dementia and mental illness, and their situation at home”, “Services that prevent the elderly from becoming dependent”, “Collaboration with other professions by participating in home visits or community center visits”, and “Work that requires comprehensive guidance on health within the community”. To clarify the nursing specialty, it is desirable to comprehensively support a team approach by utilizing each specialty in 3 job types. In addition, we suggest that general community nursing roles can be better demonstrated by developing a vision, providing accessible consultation and supervision, and outlining a clear career path as part of the educational system.
ABSTRACT
The purpose of this study was to clarify the effects of and factors that influence the burden of caregiving in relation to the caregiver's personality and interpersonal trust. The study targeted family members who were primary caregivers of elderly patients with dementia living at home and using care services such as home-visit nursing services and outpatient rehabilitation in Prefecture A. The survey was conducted using a self-administered questionnaire battery delivered to and completed at the subject's home. The battery contained questions about the subject's personal profile, the Interpersonal Trust Scale, Zarit-8 (Japanese version), the Family Adaptation and Cohesion Evaluation Scales (FACES III Japanese version), and the Medical Outcome Study MOS 8-Item Short-Form Health Survey (Japanese version SF-8). We made a comparison of the sense of care burden for elderly dementia patients living at home after dividing the subjects into two groups based on the average caregiver score on the Interpersonal Trust Scale. The group with higher interpersonal trust scores reported a significantly lower sense of care burden. It was speculated that the ability to consult with family and friends about how to build trust with others and cope with the needs of nursing care was related to the caregiver's sense of interpersonal trust. The study found that influencing factors for a sense of care burden were interpersonal trust, supporters other than family members, and family type. The findings also suggest that interpersonal trust could influence the sense of care burden.
ABSTRACT
Objective: The present study aimed to examine the role that caregiver burden plays in the familial functioning, social support, and quality of family life (QOFL) of caregivers of elderly family members with dementia. Methods: A survey was conducted with 200 primary caregivers of elderly dementia patients who resided in prefecture “S”. The questionnaire consisted of items that required demographic information, the Japanese versions of the Zarit Burden Inventory (ZBI) and the Family Adaptability and Cohesion Evaluation Scales (FACES II), and scales that measure quality of family life and social support. On the basis of the median ZBI score (i.e., 30.8), participants were divided into two groups: group A (i.e., ZBI score < 30) and group B (i.e., ZBI score > 30). Stepwise multiple regression analysis was conducted with QOFL as the dependent variable. Version 24 of the Statistical Package for the Social Sciences for Windows was used to conduct all the statistical analyses; the statistical significance level was specified as 0.05. Results: Group A and B obtained average ZBI scores of 18.5 and 43.8, respectively. The study targeted 81 patients from group A (average age = 61.0 years) and 77 patients from group B (average age = 61.7 years). Time that was spent on caregiving tasks was significantly higher for group B, when compared to group A. In addition, significant differences in cohesion and adaptability, which are two dimensions that are measured by the FACES II, and QOFL emerged between the two groups. The results of the multiple regression analysis showed that cohesion (β = 0.38), practical support (β = 0.32), adaptability (β = 0.30), and living arrangement (β = −0.12) significantly predicted QOFL. Conclusion: Family cohesion and adaptability are indicators of healthy familial functioning. In order to improve the QOFL of caregivers of elderly dementia patients, it is necessary to strengthen emotional ties, maintain emotional attachment, and flexibly respond to the burden of nursing care and changes in power structures and role relationships.
ABSTRACT
This study investigated subjective health and its associated factors among community residents who participated in a meeting on nursing care and health held at a local commercial facility. An anonymous self-administered questionnaire was distributed to a total of 441 participants. Of these, 403 responded to the questionnaire. Respondents comprised 326 healthy individuals (80.9%) and 77 unhealthy individuals (19.1%). Mean age was 66.3 ± 11.6 years. Factors significantly associated with subjective health were age, non-smoking, regular exercise, need for daily living assistance, emotional support, and psychological status. Analysis according to age (elderly group vs. non-elderly) showed that the subjective health of the non-elderly group was not significantly associated with any of the factors, while that of the elderly group was significantly associated with non-smoking, need for daily living assistance, emotional support, and psychological status. Continuation of independent daily living through efforts to maintain or improve physical function is needed to promote subjective health, especially for the elderly. It is also important to establish a support system to facilitate communication with the family and community in order to maintain good psychological health even when these individuals become physically dependent.