Introduction: This study assessed the validity and reliability of the Japanese Consultation and Relational Empathy (CARE) Measure in community pharmacist consultations.Methods: We administered an anonymous self-questionnaire about patient consultations with pharmacists to 11 community pharmacies between November 2018 and March 2019.Results: A total of 224 patients completed the questionnaire. Low numbers of missing values and 'not applicable' responses suggested high face validity of the Japanese CARE Measure. Factor analysis resulted in a single solution and internal reliability was high (Cronbach's alpha 0.943). Construct validity was supported by a significant relationship (Spearman's rho 0.43, p<0.01) with the patient's satisfaction with the consultation.Conclusion: The Japanese CARE Measure may be valid and reliable in a community pharmacy setting.

Introduction: The factors associated with the recovery of activities of daily living (ADL) in elderly inpatients have not been clarified. This study aimed to investigate the factors associated with recovery of ADL in elderly inpatients with acute infectious disease who underwent rehabilitation during their hospitalization.

Methods: The study included patients ≥65 years of age who were hospitalized due to acute infectious disease and had undergone rehabilitation at Tsukuba Memorial Hospital. The main outcome was measured using the functional independence measure (FIM) scores to assess ADL, and the recovery rate of FIM was calculated. Furthermore, the factors associated with the recovery rate of FIM were evaluated by multiple regression analysis. Basic characteristics, length of stay, length from onset to starting rehabilitation, physical status (muscle strength and presence of urinary incontinence), and mental status (cognitive and depression) at the start of rehabilitation were included as the evaluation items.

Results: Among the 124 elderly inpatients with acute infectious disease (mean ± standard deviation age, 82.5±7.7), 56 were male and 68 were female. According to the multiple regression analysis, length from onset to starting rehabilitation (β=-0.03), presence of urinary incontinence (β=-0.29), and cognitive status (β=0.01) were factors associated with the recovery rate of FIM.

Conclusion: The study results suggest that length from onset to starting rehabilitation, presence of urinary incontinence, and cognitive status are important for elderly inpatients with acute infectious disease to return to their ADL.

In 1996 we started an early exposure program of nursing and care for medical school freshmen at University of Tsukuba. The program consisted of out-of-hospital practice and in-hospital practice; 195 medical students completed the program in the 1999-2000 academic year. We analyzed students' questionnaires about satisfaction with the program after each practice and studied better settings for early exposure. Students were randomized to three out-ofhospital settings (nursing home, facilities for the elderly, and home-visit nursing) and also randomized the order of the practice (in-hospital or out-of-hospital first). The mean satisfaction score for setting was the highest for the home-visit nursing and lowest for nursing homes. The mean satisfaction score for order of practice was higher when in-hospital practice was done first.

A significant delay in identifying pre-ESRD patients is not infrequent in the U.S.A. because an early examination for proteinuria is not common, and renal disease is infrequently documented even when proteinuria and/or an elevated serum creatinine level have existed. Although there are accepted strategies for slowing the progression of renal disease such as the use of an angiotensin converting enzyme (ACE) inhibitor in diabetic patients or suboptimal blood pressure control in hypertensive patients, these strategies are seldom employed. It is also particularly alarming that the patients are often low in the overall health status, hypoalbumic, or anemic at dialysis initiation, and begin dialysis without permanent vascular access or without any education regarding dialysis therapy in many instances.

Objective : It is not known whether residents in geriatric facilities are satisfied with the rehabilitation they receive. The purpose of this study was to investigate the relationship between their satisfaction with facility services and their satisfaction with the rehabilitation they receive in geriatric facilities. An additional aim was to identify the factors related to customer satisfaction with rehabilitation.
Methods : One hundred residents in 19 geriatric facilities participated in this study. After obtaining informed consent from the residents, we conducted semi-structured interviews which included scales for facility services satisfaction, customer satisfaction with rehabilitation, and the Geriatric Depression Scale (GDS). The characteristics and conditions of the residents were investigated by interviewing the facilities' staff. For statistical analysis, we used Spearman's, rank correlation test, and multiple regression analysis.
Results : Sixty-seven percent of the subjects were women, and the mean age (±SD) was 78.2±10.4 years. Multiple regression analysis revealed that the total customer satisfaction with rehabilitation score was associated with facility service satisfaction (β=0.232, p<0.05). Significant associations were also observed with “female”(β=0.198, p<0.05), “support counselors” (β=0.269, p<0.01), and “GDS” score (β=-0.291, P< 0.01). Customer satisfaction with rehabilitation was associated with “age” (β=-0.296, p<0.01), “BI” (β=0.261, p<0.01), “satisfaction with rehabilitation time” (β=0.254, p<0.01), “satisfaction with the training environment” (β=0.206, p<0.05), “toilet training” (β=0.210, p<0.05), “bathing training” (β=-0.252, p<0.01), and “GDS” score (β=-0.258, p<0.01).
Conclusion : Customer satisfaction with rehabilitation was significantly associated with facility service satisfaction in geriatric facilities.
These data suggest that rehabilitation is an important service in geriatric facilities, and supplying a sufficient number of hours of rehabilitation and having adequate facilities for rehabilitation were important for improving satisfaction with rehabilitation services in geriatric facilities.

Purpose
Long-term elderly care of the elderly (Jap. “Ro-ro Kaigo”) is a serious problem in Japan. The purpose of this study is to reveal the current state of Ro-ro Kaigo and to evaluate the factors affecting the burden on elderly caregivers.
Method
Ninety-three households of elderly subjects participated in this study. We conducted semi-structured interviews concerning the life styles of caregivers, the burden on caregivers and the condition of elderly subjects requiring long-term care.
Results
Eighty percent or more of the caregivers were spouses, and about 40 percent of the households were not supported by family members living separately.
Moreover, the burden of care borne by the caregivers was correlated with "hours spent daily providing care", "ADL of elderly requiring long-term care" (p<0.001), "hours of sleep" (p<0.01), "subjective feeling of wellbeing", "support from family living separately", and "behavioral disorders of dementia" (p<0.05).
Conclusion
These data suggest that supporting "health promotion", "reduction of hours of caregiving", "reduction of amount of assistance with toilet activity of care recipients", and "securing enough hours of sleep" were important for maintaining home care in Ro-ro kaigo.

OBJECTIVE : The aims of this study were to clarify the characteristics of outpatients with schizophrenia receiving psychiatric nursing at home and to evaluate factors related to re-hospitalization.
METHODS : The subjects were 55 outpatients with schizophrenia who were receiving psychiatric home visits and 31 non-users. An interview was conducted based on a questionnaire on age, gender, family members, psychiatric symptoms, attitude to drug use, and self-assessment of efficacy etc.; and we examined factors related to re-hospitalization.
RESULTS : Most subjects (86%) lived with their families. The percentage that lived alone was higher among those receiving nursing visits than non-recipients. Of the average age of the nursing recipients was higher than that of the non-recipients, the mean period of hospitalization was longer and the period after discharge was shorter than for the latter. The self-assessed score for efficacy among the nursing recipients who were re-hospitalized was higher than among those who were not re-hospitalized.
CONCLUSIONS : It is suggested that schizophrenia patients with serious symptoms or without family support can live in the community by using home visits by psychiatric nurses. The visiting nurses are requested to advise the patients so that they are able to assess their own capabilities and to control their own condition.

Purpose : The purpose of the present study was to examine the relationship between respiratory function and ADL/QOL among community-dwelling elderly requiring support or care.
Methods : The study included 87 elderly aged ≥65 years who were certified to require support (yousienn)or care (youkaigo)level 1-3 and who used day care at a rehabilitation center. We evaluated their respiratory, mental, physical, and swallowing functions. ADL, IADL, and QOL were estimated using a questionnaire. Spearman's rank correlation test and multiple regression analysis were used to examine correlations of the functions with ADL/QOL.
Results : Respiratory, physical, and swallowing functions showed statistically significant correlations with ADL/IADL/QOL. Multiple regression analysis showed that forced expiratory volume in 1 second and swallowing function were related to ADL, IADL, and QOL (SF8body & mental).
Conclusion : ADL and QOL were associated with respiratory function in elderly subjects requiring support or care. Our data suggested that pulmonary rehabilitation to enhance respiratory and swallowing functions in elderly requiring support or care may improve their ADL and QOL.

Background: The current study aimed to investigate factors associated with the prognosis of activities of daily living (ADL) in elderly patients with pneumonia who had undergone rehabilitation during their hospitalization.
Methods: The study included patients of age ≥65 years who were hospitalized due to pneumonia and had undergone rehabilitation for disuse syndrome at Tsukuba Memorial Hospital. The main outcome was measured using the functional independence measure (FIM) scores to assess ADL. The participants were divided into a high-recovery group (≥80%) and a low-recovery group (<80%) based on the FIM recovery rate score. Further, factors associated with the prognosis of ADL were evaluated using multivariate logistic regression analysis. Basic characteristics, consciousness, usual mode of transportation, FIM score, grip strength, range of motion, orthostatic hypotension, exercise tolerance (6-minutes walking distance), respiratory disorder (Hugh–Jones classification), constipation, malnutrition (mini-nutritional assessment), cognitive (mini-mental state examination), depression (geriatric depression scale), balance (functional balance scale), urinary incontinence, and pressure ulcers were included as the evaluation items.
Results: Among the 51 elderly patients with pneumonia (average age ± SD; 82.0 ± 11.3), 34 patients were classified in the high-recovery group and 17 in the low-recovery group. In multivariate logistic regression analysis, it was revealed that the number of days from the onset until the initiation of rehabilitation (days of inactivity) and nutritional status were factors associated with a high-recovery FIM score.
Conclusions: The study results suggest that days of inactivity and early management of nutritional status after hospitalization are important for elderly patients with pneumonia to return to their ADL.

Objectives: The goal of the present study was to investigate the relationship between occlusal function and body composition in 108 premenopausal healthy Japanese women aged 20−45 years. Methods: Pressure-sensitive sheets were used to measure occlusal function. Whole fat mass and lean mass, fat-free mass, and whole-bone mineral content were measured by dual-energy X-ray absorptiometry (DXA). Results: After being adjusted for age and the square of height, the whole lean mass and grip strength of the large occlusal contact-area group were found to be significantly higher than those of the small occlusal area groups (p<0.05, respectively). In the 1-year follow-up study, changes in weight in the small-occlusal contact-area group and the low-occlusal force group were significantly larger than other occlusal-contact area or occlusal-force groups. The mean occlusal-contact area and occlusal force were both significantly smaller in subjects with partial dentures than in those without (p<0.05). Conclusion: Large occlusal contact-area, high occlusal force, and no dentures may be associated with some good health conditions in premenopausal Japanese women.
Japanese language ; Mass, NOS ; Body Composition ; Occlusal ; Function