Objective: This presentation is designed to clarify the sense of satisfaction entertained by home visiting nurses and nosocomial nurses and relations among the “sense of efficiency,” “work stress,” “sense of satisfaction with duty work,&rdquo and “posture toward terminal care.”　　Methods: The subjects of this study include 106 home visiting nurses and 120 nosocomial nurses and were asked about the factors cited in the Objective. 　　Results: In the group of home visiting nurses, the age and the sense of self-efficacy were high, the number of years in service was great and they had many children. In both groups, significant correlations were observed between the “sense of satisfaction with the delivery of full terminal nursing care to the last moment” and the “yardstick of attitude toward terminal care.” In the home visiting group, significant correlations were noted between the “sense of satisfaction with the delivery of full terminal care to the last moment” and the “sense of self-efficacy.” In the group of nosocomial nurses, significant correlations were witnessed in the “sense of satisfaction with the delivery of full nursing care to the last moment” and the “sense of satisfaction with hospital work.”　　Discussion and conclusion: Home visiting nurses appeared to have a high sense of self-efficacy as their ages were high and they had many years of experience in nursing care and family life.　　The sense of satisfaction with the delivery of full nursing care to the last moment was considered high among nosocomial mursesandhome visiting nurses, as they have grappled with the delivery of terminal care in a forward-looking posture.　　The sense of satisfaction with the delivery of full terminal care was presumably looked upon as having an effect on the sense of satisfaction with nursing care as a line of duty.

Object: To clarify the emotional and instrumental support influencing male caregivers for people with dementia living at home.

Patients/Materials and Methods: The subjects were 298 male caregivers. Nursing care burden was assessed using the Zarit Caregiver Burden Scale. Ability to cope with care problems was assessed using the Nursing Care Problems Coping Scale for Male Caregivers for People with Dementia Living at Home (NCSM). Emotional support was assessed using the Emotional Support Network Scale. Instrumental support was assessed using the question “Do you have someone to help when you have a problem with nursing care?”.

Results: There was a significant correlation (P < 0.04) between the point (index) of NCSM and Zarit Caregiver Burden Scale. A positive significant correlation was found in three coping styles. A negative significant correlation was found in one coping style, and no significant correlation in one coping style. The ‘Solve the problem’ coping style was linked to support from both within and beyond the family. Both ‘Emotional avoidance’ and ‘Cognitive transformation’ coping styles were linked to support from within the family, and “Request assistance” style only to external support. There were no correlations between the source of support and the “Careful supervision and waiting” coping style.

Conclusion: Emotional and instrumental support for male caregivers was more than three times more likely to be obtained from within the family than outside it. With families becoming smaller, it is becoming more important for communities and society in general to provide emotional and instrumental support for male caregivers. Male caregivers need support from someone with whom they feel comfortable. It is particularly necessary to consider how to support male caregivers who use the “Emotional avoidance” coping style.

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.

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.

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.

This article was retracted.

This study aimed to develop a scale for identifying care needs to enable family caregivers to provide appropriate care to community-dwelling elderly people with early cognitive dysfunction. We developed a draft scale taking into account 32 items of care needs for elderly people with early cognitive dysfunction based on previous studies, and we conducted a questionnaire survey with 86 primary caregivers of elderly people who attended memory loss consultations at Regional Comprehensive Support Center A and the Outpatient Memory Loss Clinic in the Department of Neurology at University Hospital B. Exploratory factor analysis revealed 3 factors consisting of 14 items: (1) family's lack of understanding of early cognitive dysfunction and caregiving, (2) confusion about caregiving and consultations, and (3) caregiving methods and prevention of deterioration with early cognitive dysfunction. Cronbach’s alpha was calculated to be 0.83 for all items, confirming the reliability of the results. In the results of confirmatory factor analysis, the model fit was goodness of fit index (GFI) = 0.89, adjusted GFI = 0.88, comparative fit index = 0.90, and root mean square error of approximation = 0.08. The Care Needs Scale for Elderly People with Early Cognitive Dysfunction consists of 14 items, and this study suggests that the scale can be used to help caregivers of elderly people with early cognitive dysfunction provide appropriate care.

Objective: This study aimed to identify the care needs of family caregivers of elderly patients with early-stage dementia and examine support measures.Materials and Methods: We conducted a self-administered questionnaire survey with 115 primary caregivers of outpatients who visited A City Community General Support Center or B University Hospital Department of Neurology for memory loss consultation. The questionnaire content included demographic characteristics, the care needs scale for caregivers of the elderly with early-stage dementia (Care Needs Scale), and the Japanese short version of the Zarit Burden Interview. The Medical Ethics Committee of Fukuoka University approved this study (approval number: M047). Of the 115 participants, 104 were included in the analysis after excluding 11 respondents with missing data. We divided the participants into a young group (under 65 years of age) and an old group (65 years of age or older) and compared the variables and each scale score using the Mann–Whitney U test. We also compared the correlations between the total score and subscale scores of the Care Needs Scale and each variable, in addition, we performed multiple regression analyses using the total score of the Care Needs Scale as the dependent variable.Results: The young caregivers wanted to know how to take care, prevent deterioration, and deal with symptoms of early-stage dementia. They were trying to balance caregiving with work and housekeeping and reduce the stress and burden of long-term care. Older caregivers were confused about caregiving and wanted someone to talk about their situations.Conclusion: Both groups shared that the family’s lack of understanding about caregiving and personal and role strains were associated with the care needs of caregivers of the elderly with early-stage dementia.

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.

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.