Comparison survey on family caregivers of older persons in Japan and Thailand.

BACKGROUND: While rapid population ageing is occurring worldwide, its speed is especially prominent in Asian countries. In Asia, cultural diversity might significantly affect care burden; however, few studies have investigated the differences in care burden, and mental, physical and social conditions among Asian countries. This study aimed to clarify the situations of and differences in family caregivers (FCs) of older persons in Japan and Thailand, and evaluate the factors associated with care burden in both countries. METHODS: A cross-national survey of 217 in-home FCs was conducted in Japan and Thailand and mainly included items regarding care burden and psychosocial conditions. Differences between the two countries were obtained, and the factors associated with care burden were analysed by multiple regression analyses. RESULTS: The FCs' and care receivers' mean ages (64.8 ± 11.1 and 84.8 ± 8.6 years, respectively) in Japan were significantly higher than the mean ages (49.1 ± 13.3 and 77.1 ± 9.5 years) in Thailand. In Japan, FCs had more severe care burden, loneliness, and stress compared to those in Thailand. In Thailand, FCs had more social connections and informal support than those in Japan. The factors associated with care burden were different in each country; thus, severe stress, low emotional care preparation, and low willingness to continue care at home were significantly associated with severe care burden in Japan, whereas poor relationships with care receivers, few social connections, low confidence in providing care, low emotional care preparation, and lack of informal support were significantly associated with severe care burden in Thailand. CONCLUSIONS: Despite there being a long-term care insurance system in Japan, which is absent in Thailand, care burden and psychosocial conditions of FCs might be worse in Japan. There was a clear difference in the factors associated with care burden between Japan and Thailand.

Effects of a virtual reality intervention on dementia care education among acute care nurses in Japan: A non-randomised controlled trial.

This study aimed to evaluate the effects of a virtual reality intervention for dementia care education in Japanese acute care nurses. Non-randomised controlled trial was used to assess the effectiveness of the intervention pre- and post-intervention and at a 1-month follow-up. This study enrolled 20 and 19 nurses in the intervention and control groups, respectively. Generalized estimating equation analyses revealed significant differences in scores on the Dementia Nursing Competency Scale in Acute Hospitals and Staff Experiences of Working with Dementia Residents questionnaire in the intervention group. A post hoc test revealed significantly higher scores on the Dementia Nursing Competency Scale in Acute Hospitals at 1 month after compared with pre-intervention. Staff Experiences of Working with Dementia Residents questionnaire scores were significantly lower at pre- than that at post-intervention and 1 month after intervention. These findings could improve competency of dementia nursing care and attitudes toward people with dementia.

The Impact of Cognitive Impairment on Disaster Preparedness: A Cross-sectional Study of Older Adults over the Age of 75 Requiring Special Care in Japan.

Disaster preparedness is the most important measure that can be taken to reduce damage. However, disaster preparedness is predicted to be difficult for older adults with cognitive impairment. Thus, we investigated the effects on disaster preparedness of cognitive impairment in persons requiring special care who are 75 or older. The survey included subject characteristics such as demographic indicators, physical function, cognitive function impairments, community involvement, and disaster preparedness. Cross-sectional data from 711 subjects were divided into two groups, a cognitive impairment group and an unimpaired group. Next, to show the effects of subject characteristics in each group on disaster preparedness, a binomial logistic regression analysis was performed. Then, the effects on disaster preparedness were compared between the two groups. This study showed that persons requiring special care who are 75 or older, and have the characteristics of "living alone," "requiring care," and "needing mobility assistance" in addition to cognitive impairment, have increased difficulty making disaster preparedness. Government officials and community supporters therefore need to recognize that these people should be supported on a priority basis, and to provide continuing support for disaster preparedness.

Disaster Preparedness of Persons Requiring Special Care Ages 75 Years and Older Living in Areas at High Risk of Earthquake Disasters: A Cross-Sectional Study From the Pacific Coast Region of Western Japan.

OBJECTIVE: The aims of this study were to examine the preparedness of vulnerable people ages 75 years and older and to clarify the characteristics of older adults that are associated with disaster preparedness. METHODS: We conducted interviews with persons requiring special care ages 75 years and older living in coastal communities of western Japan, where earthquakes and tsunami disasters are a concern. The survey included participant characteristics such as demographic indicators, physical function, health status, community involvement, and disaster preparedness. Binomial logistic regression analysis was performed with participant characteristics as independent variables and disaster preparedness as the dependent variables. RESULTS: The characteristics related to disaster preparedness were age, family composition, cognitive function, level of interaction with neighbors, and participation in community activities. CONCLUSIONS: Being female, living alone, and having cognitive impairment were factors that led to decreased disaster preparedness. However, it was suggested that close human interactions in the community facilitated preparedness. Community engagement is crucial in reducing disaster damage and recovering effectively. In order to facilitate preparedness measures for persons requiring special care ages 75 and older, it is important to establish community preparedness.

Bacteremic kidney cyst infection caused by Helicobacter cinaedi.

Cyst infection is one of the major complications in patients with autosomal dominant polycystic kidney disease (ADPKD). The causative pathogen in kidney cyst infection frequently goes undetected. Although only one case report of kidney cyst infection caused by Helicobacter cinaedi (H. cinaedi) is published in English literature, it may be an important pathogen in kidney cyst infection. Kidney cyst infection and H. cinaedi infection share the common characteristic of tendency to relapse and chronic kidney disease is a major risk factor for H. cinaedi infection. Moreover, a long period is required to detect H. cinaedi in blood cultures, potentially causing false-negative results. After the identification of H. cinaedi, we must carefully select antibiotics and the antibiotic treatment period should be extended to prevent recurrence. Here we present a case of a 58-year-old male with ADPKD who developed bacteremic kidney cyst infection caused by H. cinaedi. He was admitted to our hospital because of fever, lower left back pain, vomiting, and feeling of abdominal enlargement. H. cinaedi was detected from the blood cultures obtained at admission after 4 days of culture. Antibiotics were administered for 8 weeks after confirming negative blood cultures. There was no evidence of kidney cyst infection relapse at 3 months after treatment completion. Nephrologists should regard H. cinaedi as a challenging but important pathogen in kidney cyst infection, particularly when the causative organism is unknown or kidney cyst infection is recurrent.

Care managers' views on death and caring for older cancer patients in Japan.

Care managers (CMs) have an important role in coordinating care for cancer patients who are in the end-of-life stage; however, little is known about their views of death and their experiences while caring for older cancer patients. This study was conducted to examine CMs' views of death and caring for older cancer patients in a home care setting in Japan. Convenience sampling was undertaken, and 35 offices from 43 approached services agreed to participate. The final valid sample included responses from 136 CMs (90.7%). Most CMs, including nurses, care workers, home helpers, and social workers in home care settings, experienced difficulty in managing the care of cancer patients in the end-of-life stage. Respondents reported a wide array of experiences with end-of-life care, care management, and seminar attendance, and their ages and Frommelt Attitude Toward Care of the Dying (FATCOD) scores were associated factors. Moreover, multiple regression analysis indicated that better attitudes toward caring for the dying were positively associated with seminar attendance. These results suggest that CMs need education about palliative and end-of-life care in order to promote good home care for cancer patients.