Aims: This study sought to confirm the validity and reliability of the Dialogue Preference Scales for Elderly (DPSE). Methods: Based on data from preceding research, a 15-item measurement model was developed, for which construct validity, concurrent validity, and reliability were examined. Concurrent validity was also examined for six measures applied to other students. Results and discussion: The path coefficients of the resulting four relationship-related DPSE factors were: bewilderment (0.84); anxiety (0.54); bias (0.37) and communication (0.74). The indices of fit for the DPSE model were 0.952 for GFI, and 0.933 for AGFI. Distinction between factors was good, thereby confirming construct validity. Using the split-half reliability method, the correlation co-efficient was ρ=0.74(p<0.001) and the reliability co-efficient was from 0.76 to 0.67 for each factor, confirming high internal consistency. The average score of good-poor groups in all items for the Good-Poor Analysis was significant, and confirmed reliability. A negative significant correlation was detected between the DPSE and the Assertive Mind Scale and the Empathetic Understanding Measure. Factor two, anxiety in the relationship, correlated significantly with authoritative anxiety (r=0.73, p<0.01), thereby confirming part of concurrent validity. Conclusions: The DPSE is a four-factor 15-item scale with confirmed validity and reliability. This scale assessed nursing students' negative tendencies in cognition and attitudes when conversing with elderly clients. Specific correlation with each factor was found, and the features and independence of factors were proved.

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The purpose of this study was to evaluate the effectiveness of a home hazard modification program (HHMP) for preventing elders' falls in their own residence. HHMP was a 30-minute educational program to create a safer living environment by decreasing residents' fall risks and hazards. The HHMP consisted of short lectures, risks and hazards home assessment and improving safety. Educational materials consisted of a mock-up of a Japanese-style house (Japanese registered utility model ID3148203), and specific tools designed to increase home safety. The HHMP was part of a fall prevention practice held two hours each week for four weeks with a follow-up class at three months and a final class one year later. Consenting to participate was a convenience sample of 73 elders (mean age 76.7 SD 6.2) from the community randomly assigned to the intervention (n=38) or control group (n=35). Completing the 12-week HHMP were 27 (71.1%) in the intervention group and 29 (82.9%) in the control group. Data, such as a 10-item hazard knowledge test and Flemming Fall Risk Assessment were analyzed using repeated measures ANOVA at three times: (a) baseline, (b) end of the class, and (c) after twelve weeks. Probability of falling was analyzed using survivor analysis: Kaplan-Meier analysis and log-rank test. As a result, the intervention group's knowledge of home hazard and safety showed a significant interaction effect (p=.047) and a simple main effect (p=.033) between baseline and end of the class (Bonferroni's multiple comparison test p=.027). Only low-risk elders in the intervention group showed significantly higher correct responses on the preventing falls on the three-point scale item, between baseline and end of the class (Fisher's exact test p=.020), and after twelve weeks (Fisher's exact test p=.047). Moreover the number of falls was significantly lower in the intervention group compared to the control group (log-rank test p=.025). Our HHMP has the possibility for short-term fall prevention and improved knowledge of hazards for elders living in the community.

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The purpose of this study was to investigate factors on admission indicating the risk of delirium early after admission in elderly patients who were admitted to hospital for acute-stage medical treatment and experienced rapid environmental changes. The subjects were two hundreds of medical inpatients aged 70 years or older, admitted to general hospitals. Of the 200 patients, 21 developed delirium (incidence 10.5%) within 3 days after admission. Logistic regression identified nine variables related to incidence of delirium: alcohol consumption (OR=185.7, p=.019, 95% CI=2.4 to 14515.5), bad falling asleep (OR=159.5, p=.025, 95% CI=1.9 to 13476.6), benzodiazepine (OR=144.8, p=.012, 95% CI=3.0 to 6884.2), anxiety (OR=116.0, p=.020, 95% CI=2.1 to 6434.7), fasting (OR=95.8, p=.024, 95% CI=1.8 to 5090.1), dissatisfaction (OR=68.7, p=.039, 95% CI=1.2 to 3787.6), 200mg/dl higher of blood sugar (OR=39.9, p=.048, 95% CI=1.0 to 1549.8), disorientation (OR=28.7, p=.019, 95% CI=1.7 to 472.2), and constipation (OR=15.6, p=.033, 95% CI=1.2 to 197.0). The risk factors for delirium developed in this research incorporate the nursing perspective that patients as human beings are stimulated and reacting to their environment; this is different from the conventional medical model. The model shows promise for predicting delirium among elderly people admitted to hospitals for acute care and points the way to nursing care to prevent its onset.

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[in Japanese]

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[in Japanese]

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