Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 50 , Issue 1
Showing 1-27 articles out of 27 articles from the selected issue
The 54th Annual Meeting of the Japan Geriatrics Society
Special Lecture
Meet the Expert
Symposium 8: The care of the elderly patients with diabetes mellitus: A synthesis of findings from J-EDIT
Panel Discussion 2: Disaster medicine for the elderly
Original Articles
  • Chikako Tange, Yukiko Nishita, Makiko Tomida, Fujiko Ando, Hiroshi Shi ...
    2013 Volume 50 Issue 1 Pages 88-95
    Published: 2013
    Released: August 06, 2013
    Aim: The purpose of this study was to construct a scale that measures multidimensional attitudes regarding death in the middle-aged and elderly, using scale items for adolescents, and to examine its reliability and validity.
    Methods: Twenty-nine items which were selected from the scale of Attitudes toward Death (Tange, 1999) were administered to subjects, consisting of 2,223 community-living Japanese men and women aged 40-79 years. Both exploratory factor analysis and confirmatory factor analysis were performed to examine the factor structures. The reliability and validity of the scale were examined.
    Results: Exploratory factor analysis was performed to examine the factor structures of death attitudes, using the data from half of the subjects, indicated 5 factors. Confirmatory factor analysis, using the data from the remaining half, supported the goodness of fit of that model. Using this structure, the attitude toward death scale for the middle-aged and elderly (ATDS-A; five subscales) was constructed; "fear of death", "belief in existence of afterlife", "intention to live out own life", "meaning of death for life", "approval of death with dignity". For these subscales, the alpha coefficients ranged from 0.59-0.87. The validity of the subscales was suggested through the relation with the ego integration score.
    Conclusions: This study suggested that the ATDS-A was reliable and valid, and was useful for the measurement of death attitudes in the middle-aged and elderly.
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  • Takeshi Sato, Kazunori Sato
    2013 Volume 50 Issue 1 Pages 96-103
    Published: 2013
    Released: August 06, 2013
    Objective: Percutaneous endoscopic gastrostomy (PEG) serves as a major artificial hydration/feeding method in the terminal care of elderly patients. We surveyed the state of patients who underwent PEG at our hospital and investigated the clinical characteristics of patients in the long-term survival group, and the short-term survival group.
    Methods: The subjects were 125 patients who underwent PEG at our hospital between January 2007 and June 2011. Two kinds of examination were performed. In the first examination, subjects were divided into a short-term group of 37 patients who survived <181 days and a long-term group of 88 patients who survived ≥181 days. In the second examination, subjects were divided into 2 purpose-oriented groups: a prolongation of life group of 76 patients and a being able to eat group of 49 patients. We analyzed the clinical records of these patients and conducted a telephone-based survey.
    Results: In the short-term group, there were many cases of PEG after hospitalization due to medical diseases such as pneumonia. In the long-term group, many subjects were young, female, suffered from recurrence of cranial nerve disease, or slowly developed dysphagia. The involvement of rehabilitation doctors, the rate of undergoing rehabilitation for dysphagia, and cases who were able to achieve oral ingestion were significantly high. Of 49 patients who underwent PEG with the aim of being able to eat, 24 achieved oral ingestion.
    Conclusion: Our findings suggest that involving rehabilitation doctors and undergoing rehabilitation for swallowing effectively promote long-term survival after PEG.
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  • Yukiko Tanaka
    2013 Volume 50 Issue 1 Pages 104-109
    Published: 2013
    Released: August 06, 2013
    Aim: The purpose of this study is to consider the influence which the form of tube feeding nutrition products has on meal delivery operating man-hours, personnel expense, and the quality of nursing. In addition, it is also considers operational efficiency improvement.
    Methods: We used liquid nutrition material packaged in a paper container before we changed the nutrition product. After the change of the nutrition product, semi-solid nutrition with ready to hang (RTH) moderately viscous nutrition was used. We investigated the tube feeding administrative task and the contents of nursing using the Industry Engineering technique.
    Results: We were able to reduce by half the man-hours required for 1 morning tube feeding in 238.1 minutes to 106.1 minutes by changing to RTH semi-solid nutrition. Thereby, we were able to reduce personnel expenses by 514,290 yen per month. The total man-hours which could be spent on nursing increased to 170 from 139.
    Conclusions: By using the RTH semi-solid nutrition with moderate viscosity, the operating efficiency of tube feeding management has improved greatly. As a result, the time which can be spent on nursing increased.
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  • Hiroko Miura, Shuichi Hara, Naoko Morisaki, Kiyoko Yamasaki
    2013 Volume 50 Issue 1 Pages 110-115
    Published: 2013
    Released: August 06, 2013
    Aim: The purpose of the present study was to examine the relationship between comprehensive quality of life (QOL) and some factors regarding chewing and swallowing function among community-dwelling elderly individuals.
    Methods: The subjects were 675 independent elderly persons residing in the northern area of Miyazaki Prefecture, and we obtained the self-administered questionnaires from 545 elderly people. We used "active scale for the elderly (ASE)" and "dysphagia risk assessment for the community-dwelling elderly (DRACE)" to evaluate their comprehensive QOL and function of chewing and swallowing, respectively. Furthermore, we examined some factors such as age, gender, subjective satisfaction with diet and verbal communication.
    Results: The score of ASE showed a significant decline with age (p<0.01) while the DRACE score increased significantly with age (p<0.01). Pearson's correlation coefficients revealed that the ASE score was significantly related to all of the factors regarding regulation of food intake. Partial correlation coefficients adjusted for age also revealed the same tendency. From the multiple regression analysis, subjective satisfaction with verbal communication, DRACE score, age and appetite were extracted as factors influencing ASE score (adjusted R2=0.43, p<0.01).
    Conclusion: Among independent elderly persons residing in the community, the comprehensive QOL was significantly related to factors such as subjective satisfaction with verbal communication, dysphagia risk, age, and appetite.
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Special Articles
IAGG Master Class on Ageing in Asia
Letters to the Editor