Purpose : This study examined the effects of a self-efficacy improvement program (SE improvement PGM) on the care given by family caregivers for behavioral and psychological symptoms of dementia (BPSD).
Methods : A total of 57 caregivers were studied. Twenty five were placed in the control group (CG) and 32 in the intervention group (IG). A program consisting of information on dementia, interaction with other caregivers, and relaxation techniques was provided to both groups. The IG was also provided the SE improvement PGM. The primary outcome studied was degree of self-efficacy, while the appearance of BPSD and sense of burden, depressive moods, and knowledge regarding dementia were assessed as secondary outcomes.. The effects of the program were examined using questionnaires, such as the Japanese version of the revised scale for caregiving self-efficacy (J-RSCSE), Neuropsychiatric Inventory-Brief Questionnaire Form (NPI-Q), Zarit Caregiver Burden Interview (J-ZBI_8Y), Geriatric Depression Scale short version (GDS5), and Alzheimer Disease of Knowledge Scale (J-ADKS), which the subjects answered at pre- and, post-program, and at two-months (2M) post-program.
Results : The SE-Responding to Disruptive Patient Behaviors (SE-RDPB) scores for the J-RSCSE subscale was significantly improved in the IG as compared to the CG at pre- and 2M-post-program (difference of scores ; 9.9±17.8, p<.001). Analysis of covariance using age, gender, and degree of autonomy, as covariates, showed that the SE-RDPB scores of the IG were significantly improved compared with those of the CG (F=6.15, p=.02).
Conclusion : SE improvement PGM significantly improves the self-efficacy of dementia caregivers, especially, in the context of SE-RDPB.

Purpose: To clarify the strengths and problems of nursing in multifunctional long-term care in a small group home and home-visit nursing (MLSH).Methods: Selected case reports using Ichushi, the Current Index to Japanese Nursing Literature, and DiaL were extracted and categorized based on the descriptions of the strengths and issues of service in MLSH.Results: Strengths included "flexible and continual? users / family support", "care of users with high medical needs, including end-of-life care", "support for a smooth transition from hospital to home with consecutive stay", "reduction of economic burden of users using a fixed monthly system", and "cooperation between nurses and care workers, and growth by learning from each other". Problems included "difficulty in dealing with diverse needs", "economic burden of low-income users and welfare equipment", and "insufficient cooperation with other occupations inside and outside the office".Conclusion: The strengths of service in MLSH were demonstrated via the support of users with high medical needs and support during the transition period at home. The economic burden of users and cooperation with other occupations are both strengths and problems to be addressed. Support according to user characteristics and public awareness of the existence and strengths of MLSH are required.

Introduction: In Japan, multifunctional long-term care in small group homes and home-visit nursing (MLSH) was created for elderly people who continue to live in the community as one of the long-term care insurance services. The aim of this study was to clarify the benefits and challenges of, and ideas for nursing in MLSH.Methods: A semi-structured interview survey was administered to 11 nurses carrying out MLSH in the Kansai region, and the responses were analyzed qualitatively and descriptively.Results: The benefits of nursing were divided into five categories, including "nurses' expertise and ingenuity can be utilized" and "nursing can continue to support home life even in difficult cases." There were seven categories of challenges, including "difficult to judge, educate, and collaborate; this burdens nurses" and "difficult to educate and collaborate with care workers." There were six categories of nursing ideas, including "utilize knowledge and connections from study sessions, and external training at facilities" and "ensure that nurses and care workers can provide unified care." Conclusion: Although nurses considered it an advantage to support patients' home-based life in cooperation with patients' family members using professional originality, it was difficult for them to judge, learn, and collaborate with others. Moreover, nurses faced burdens. Strategies must be developed to provide nurses with training inside and outside of the facility, and also to strengthen connections with external resources. It is necessary to further review the system and disseminate knowledge about MLSH.