Evaluation of the usefulness of a simple touch-panel method for the screening of dementia.

In clinical settings, Hasegawa's dementia scale, revised (HDS-R), and the mini-mental state examination (MMSE) are widely employed as simple mental function tests useful for the diagnosis of dementia. In recent years, for the early diagnosis of dementia, a simple computerized touch panel-type screening test (touch panel-type screening test), called the "forgetfulness consultation program" (Nihon Kohden Corp.), has been developed. We performed dementia screening using this touch panel-type screening test in 95 elderly subjects, and evaluated its usefulness in comparison with HDS-R or MMSE. The results of evaluation using the touch panel-type screening test were significantly correlated with those using HDS-R and MMSE in the elderly subjects. This touch panel-type screening test was not time-consuming (about 3 min) since it includes only a small number of test items. It could also be performed solely by the examinee, and so was free from examiner-related bias. Therefore, this method may be very useful for the diagnosis of dementia and evaluation of its severity.

A case of informed consent obtained from a patient with terminal cancer and his family using family function by the primary care physician.

We evaluated the contents and characteristics of informed consent obtained by the primary care physician from a male patient with advanced cancer and his family, and clarified the influences of the informed consent on family function. This patient was diagnosed as having advanced cancer at the age of 46 years, underwent surgery/chemotherapy, but died after 4 months at the hospital. Semi-structured interviews were held with the elder daughter of the patient, and notes on the patient's disease, the course of treatment, his family's responses, and the informed consent obtained by the primary care physician were taken during the interview. The informed consent obtained by the primary care physician had the following characteristics: (1) The physician transmitted accurate and detailed information on the treatment methods, side effects, and prognosis by appropriate communication techniques with consideration for the feelings of the patient and his family, and proposed choices so that they could participate in the decision of treatment principles. (2) During the entire course, the primary care physician frequently visited the bedside and encouraged the patient and his family to express their feelings of anxiety and to ask questions, giving continuous emotional support. With the progression of the disease and explanation by the primary care physician, the patient and his family expressed and shared feelings such as grief and powerlessness and supported each another. Gradually, they began to show practical/adaptive coping behavior and could accept the patient's death. Appropriate informed consent obtained by the primary-care physician promoted the family function of this family.