Translation and validation of the Schizophrenia Caregiver Questionnaire - Japanese version (J-SCQ).

The Schizophrenia Caregiver Questionnaire (SCQ) was developed to evaluate the state of family members caring for schizophrenics. Our study aimed to construct a Japanese version of the SCQ (J-SCQ) based on its English version and verify its reliability and validity. We conducted forward and backwards translations and cognitive debriefing to draw up the J-SCQ. A total of 1229 survey sheets were mailed, together with the Japanese versions of the Medical Outcomes Study Short-Form version 2 (SF-12v2) and World Health Organization Quality of Life Scale (WHOQOL-26) questionnaires. A total of 305 survey sheets (valid response rate: 68.2%) were analyzed. The Cronbach's alpha coefficients of various supra-domains and subdomains of the J-SCQ were over 0.71, establishing its internal consistency. Pearson's correlation coefficients between the various domains of the SF-12v2 and WHOQOL-26 was used to establish concurrent validity. The results show that the J-SCQ may be a useful Japanese questionnaire that can compare Japanese caregivers to those across different countries and measure the effects of support and intervention provided to caregivers.

Spirituality and associated factors among cancer patients undergoing chemotherapy.

AIM: Patients' spirituality, the relationship between spirituality and physical pain, and the association between spirituality and quality of life (QOL) among patients undergoing cancer chemotherapy were examined. Spirituality was defined as a sense of meaning in one's existence and life, peace of mind, and the strength and comfort drawn from faith. METHODS: A cross-sectional questionnaire survey was distributed to 176 adult cancer patients who received chemotherapy in May-September 2011 at an outpatient clinic in rural Japan. Spirituality was measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12). Demographic data were collected for performance status, cancer stage, age, marital status, occupational status, persons in household, pain intensity, and other troubling symptoms. The relationship between the patients' spirituality subscale score and QOL was assessed in a structural equation model. RESULTS: Two FACIT-Sp-12 subscales, meaning/peace and faith, were moderately to strongly associated with age, appetite, and QOL scores. Although physical pain was significantly related to the QOL score (P = .002), it was not related to the FACIT-Sp-12 score (P = .427). These results indicated that the patients with higher spiritual scores and severe pain were enjoying life more than the patients with lower spiritual scores and severe pain. Moreover, two subscales of the FACIT-Sp-12 had a direct effect on QOL. CONCLUSIONS: Spirituality was strongly associated with QOL. Younger patients (<50 years old) and stage I cancer patients need additional assistance to meet their spiritual needs. To maintain cancer patients' spiritual well-being, nursing interventions should facilitate patients' nutrition support and appropriately address their spirituality.

Differences between family caregivers and people with dementia in recognizing the difficulties encountered in the lives of people with dementia.

Objectives Dementia brings new difficulties in the lives of people with this disorder. It is important that family caregivers accurately recognize these difficulties to help their family members live fulfilling lives. Based on information gathered from people with dementia, family caregivers, and nurses providing medical care to this population, this study compared the differences in perspectives related to the difficulties associated with dementia between the family member with dementia and the family caregiver.Methods The primary participants in this investigation were 106 people with dementia and their family caregivers. Participants with dementia were 65 years and older who were receiving home care in Tokyo. Participants were interviewed about their difficulties while family caregivers completed a questionnaire with basic information regarding people with dementia. Additionally, the nurse providing medical care to the person with dementia completed a questionnaire about the medical care. In this study, difficulties in the lives of people with dementia was defined as impediments in life due to dementia. Difficulties were classified according to 12 symptoms based on responses that appeared frequently in the interviews. The 12 symptoms were pain, hallucinations/delusions, aggressive behavior, memory loss, disorientation, communication impairment, anxiety/confusion, toileting problems, gait disturbance, dietary deficiency, sleep disorder, and social withdrawal. Additional information was gathered and analyzed that included diagnosis and severity of dementia, need for long-term care, core symptoms of dementia, behavioral and psychological symptoms of dementia (BPSD), and delirium.Results The family caregiver's perspective about the difficulties encountered in the life of their family member with dementia was often different from the perspective of the associated family member. No family caregivers recognized that pain was a difficulty, and there were only a few cases in which pain was treated. Alternatively, many family caregivers recognized that hallucinations/delusions and aggressive behavior were difficulties experienced by people with dementia. There was also a significant correlation between the experience of pain and the presence of a sleep disorder.Conclusion The present results clarified the differences between family caregivers and people with dementia by recognizing the difficulties in life experienced by people with dementia. Such difficulties are not solved by the care performed by family caregivers alone. Further investigation is needed to identify those factors that enable people with dementia to live fulfilling lives.

A randomized cross-over study of a traditional Japanese medicine (kampo), yokukansan, in the treatment of the behavioural and psychological symptoms of dementia.

The effectiveness and safety of yokukansan (TJ-54), a traditional Japanese medicine (kampo) for the treatment of the behavioural and psychological symptoms of dementia (BPSD), were evaluated in 106 patients diagnosed as having Alzheimer's disease (AD) (including mixed-type dementia) or dementia with Lewy bodies. Patients were randomly assigned to group A (TJ-54 treatment in period I and no treatment in period II; each period lasting 4 wk) or group B (no treatment in period I and TJ-54 treatment in period II). BPSD and cognitive functions were evaluated using the Neuropsychiatric Inventory (NPI) and the Mini-Mental State Examination (MMSE), respectively. Activities of daily living (ADL) were evaluated using Instrumental Activities of Daily Living (IADL) in outpatients and the Barthel Index in in-patients. For the safety evaluation, adverse events were investigated. Significant improvements in mean total NPI score associated with TJ-54 treatment were observed in both periods (Wilcoxon test, p=0.040 in period I and p=0.048 in period II). The mean NPI scores significantly improved during TJ-54 treatment in groups A and B (p=0.002 and p=0.007, respectively) but not during periods of no treatment. Among the NPI subscales, significant improvements were observed in delusions, hallucinations, agitation/aggression, depression, anxiety, and irritability/lability. The effects of TJ-54 persisted for 1 month without any psychological withdrawal symptoms in group A. TJ-54 did not show any effect on either cognitive function or ADL. No serious adverse reactions were observed. The present study suggests that TJ-54 is an effective and well-tolerated treatment for patients with BPSD.

[Structural quantification in osteoarthritis of the knee using power spectral analysis].

An exact diagnosis of osteoarthritis is very important to prevent deterioration of ADL (activities of daily living) of the elderly. However, it is very difficult to diagnose the stage of osteoarthritis, and only a few indices for structural quantification of osteoarthritis have been reported. The purpose of this research is to investigate a new index for the bone structure in osteoarthritis. We examined right knees of 41 women aged from 34 to 85 years. Directivity index (DI) is a new index of bone structure calculated by directivity of the power spectrum from radiographs of tibial bone using fast Fourier transform (FFT). DI was obtained by subtracting the integral power value at 0 and 90 degree directions on the x-y plane of the two-dimensional power spectrum of tibial bone from the integral power value at a direction of 45 degrees. A significant relationship between the state of the knee joint by X-ray inspection and DI was indicated by evaluation of the correlation coefficient. However, no significant relationship was found between the state of the knee joint by X-ray inspection and the first moment of the Fourier power spectrum or the fractal dimension. There is a possibility that DI can estimate slight deformation of bone structure in osteoarthritis. In the future, we will apply DI to the prevention of osteoarthritis and a deterioration of ADL in the elderly.