The purpose of this study was to develop a recurrence risk perception scale that measures subjective perceptions of how older adults with mild ischemic stroke perceive an undesirable uncertain event such as a recurrent ischemic stroke, along with their fears. Based on previous research, a Recurrence Risk Perception Scale consisting of 17 items and a Recurrence Optimism Scale consisting of 15 items were developed. Subsequently, to evaluate the reliability and validity of the scales, we conducted a questionnaire survey of 101 elderly patients (aged 65 years or older) with mild ischemic stroke who were hospitalized at 22 neurosurgical hospitals in Japan, using a random sampling method. An exploratory factor analysis identified 3 factors and 12 items for a “Recurrence Risk Perception Scale” and 3 factors and 10 items for a “Recurrence Optimism Scale” The Cronbach's alpha coefficient of the “Recurrence Risk Perception Scale” was 0.88, and that of the “Recurrence Optimism Scale” was 0.81. Retesting for stability resulted in an intraclass correlation (ICC) of .85 for the “Perceived Risk of Recurrence Scale” and an ICC of .48 for the “Recurrence Optimism Scale. Regarding criterion validity, the correlation coefficient between the “Recurrence Risk Perception Scale” and the UUIS was .60, and the correlation coefficient between the “Recurrence Optimism Scale” and the UUIS was -.38. The reliability and validity of the “Recurrence Risk Perception Scale” and the “Recurrence Optimism Scale” were thus confirmed.

  The purpose of this study is to examine the reliability and validity of a nursing practice scale for relieving discomfort in older adults receiving long-term medical care. We prepared items based on the literature, developed a draft scale with 48 items that were reviewed for content validity, and conducted a survey on nurses working in facilities with long-term care beds to examine the reliability and validity. As a result of exploratory factor analysis, the following five factors with 41 items were included in the scale: [Practices to capture signs of discomfort], [Practices to identify discomfort], [Practices to identify wishes and needs], [Practices to prevent or relieve discomfort through interprofessional collaboration], and [Practices to protect the dignity of the older adults in day-to-day involvement]. Cronbach’s αcoefficients were 0.948 for all and between 0.824 and 0.902 for each factor, demonstrating internal consistency. The correlation coefficient with external criteria was 0.706, demonstrating concurrent validity. Furthermore, the goodness-of-fit to the model with the practice of care to relieve the discomfort of older adults receiving long-term medical care as the first-order factor and the extracted five factors as the second-order factor were CFI=0.919 and RMSEA=0.070, respectively, demonstrating construct validity. This scale can be used by nurses to reflect on their nursing practice to relieve discomfort in older adults and to improve their own nursing practice. It is expected that this will contribute to preventing and relieving discomfort and bringing comfort in older adults.

  Purpose: The study aims to clarify effects of blowing exercise using a Party-horn and the one of criteria (independent variables) of nursing intervention in an intake of medium chain triglyceride (MCT) [12g per day] on oral functions of older people with dementia and sarcopenia living in a group home.

  Methods: Aiming at older people with dementia and sarcopenia living in a group home, 12-weeks intervention period was set after 12-weeks baseline period. During the intervention period, all of them took MCT, and they were allocated to two groups: a group of MCT and one of MCT with blowing exercise using the Party-horn. Oral functions (tongue pressure, oral diadochokinesis, repetitive saliva swallowing test) were measured three times (before and after the baseline period and after the intervention period).

  Results: Comparing the number of changes in the group of MCT and those in the group of MCT with the blowing exercise using the Party-horn, there was a significant difference in the tongue pressure (p<.049).

  Conclusions: Consequently, it is suggested that combination therapy with the blowing exercise using the Party-horn may increase the tongue pressure.

  In this study, semi-structured interviews were conducted with eight family caregivers of older adults with dementia to identify what supported them during the period between the onset of dementia symptoms until a community support system was in place. The analysis of interview data generated nine categories: being prepared for caregiving; the older adult with dementia maintaining peace of mind; desire to provide quality time for the older adult with dementia; caregiver's wish to personally care for the older adult with dementia; receiving words of acceptance or encouragement regarding dementia; having someone who could empathize with the caregiver's feelings; discovering personal methods, strategies, and meaning in caregiving; having family oversight and understanding; and professionals responding appropriately to the situation. The findings suggest the importance of nurses identifying and supporting the strengths of family caregivers and providing emotional support to both the family caregivers and the older adults with dementia, to help maintain a stable environment for both.

  This study aimed to identify nursing practice for hypoactive delirium in older adults with dementia. Semi-structured interviews were conducted with six nurses certified in dementia nursing (DCN) and analyzed qualitatively and descriptively. The result was that the DCNs were [suspecting that something is going on due to lack of activity and response], [searching around to know what was going on], and [screening possibility of hypoactive delirium], then [identifying hypoactive delirium based on characteristic daily changes]. In addition, from the stage when hypoactive delirium could not be identified, [promoting to wake the patient up with sunlight or touching stimulation] and [promoting wakefulness by increasing sensory simulation while being careful not to overload] were used to [supporting patient to maintain wakefulness]. The DCNs repeatedly performed careful observation and exploration of the older adults with dementia and provided sensory stimulation using different methods according to their level of consciousness. These practices were thought to prevent the older adults with dementia from overlooking hypoactive delirium and to improve their awareness and cognitive impairment according to their level of consciousness.

Objective: This study aims to explore the implementation methods of in-hospital daycare services provided at medical institutions that employ a Certified Nurse Specialist in Gerontological Nursing (GCNS) or a Certified Nurse in Dementia Nursing (DCN). Additionally, the characteristics of facilities that continued to provide these services throughout the COVID-19 pandemic and the changes introduced for infection prevention are identified. The overarching objective is to gain insights into how in-hospital daycare services can be sustainably provided.

Methods: An online questionnaire survey was conducted targeting 1,101 medical institutions that employ GCNSs or DCNs.

Results: The response rate was 24.8%. During the pandemic, 38 institutions (14%) continued to provide in-hospital daycare services. Among such facilities, significantly more cited “prevention and improvement of Behavioral and Psychological Symptoms of Dementia and delirium” as a primary goal, compared with those that suspended services during the pandemic. To adapt to the pandemic, various measures were implemented, such as reducing the number of patients, modifying or restricting programs, and decreasing staff numbers.

Discussion: GCNSs and DCNs demonstrated flexibility in their approach, continually evaluating whether in-hospital daycare should be continued or suspended while striving to provide better care for patients with dementia. The study suggests that in-hospital daycare needs to be implemented in a way that is consistent with the needs of patients with dementia, such as preventing deterioration of motivation and BPSD, and responding to a sense of isolation, in order to ensure its continuous operation.

  This study aimed to identify the practices of dementia nursing education in lectures and practical training within a baccalaureate program. Semi-structured interviews were conducted with 11 faculty members teaching dementia nursing and analyzed qualitatively. Eight categories were identified about the practices of dementia nursing education. “Providing opportunities to learn the experiences of older people with dementia, leading to a deeper, more empathetic understanding,” “Emphasizing the importance of bringing out the strengths of older people with dementia using concrete examples for memorable learning,” “Adapting educational methods to suit students who struggle with understanding cognitive impairment,” “Explaining the realities of family care and support to family caregivers to enhance understanding and provide assistance,” “Explaining specific methods to recognize the needs and distress of individuals with dementia, which may be difficult to express verbally, and providing appropriate care,” “Providing opportunities to learn about the realities of the field to understand the necessity of multidisciplinary cooperation,” “Enhancing ethical sensitivity by providing opportunities to consider ethical issues from the perspective of older people with dementia,” and “Encouraging students to examine their perceptions of older people with dementia and foster interest in them as participants in nursing”. Overall, the teaching activities in dementia nursing education within a baccalaureate program, encompassing both lectures and practical training, aim to deepen the understanding of the subject by providing insights into the actual experience of older people with dementia and their family caregivers, promoting a basic understanding of the support features of dementia nursing, enhancing ethical sensitivity, cultivating a philosophy of dementia, and leveraging the characteristics of a university that is involved in community service.

  This study aimed to identify nursing practices that promote “mobility” in older patients hospitalized in acute care hospitals through the practices of certified nurse specialists in gerontological nursing. Data were collected through semi-structured interviews with 12 certified nurse specialists in gerontological nursing about their nursing practices with older patients in acute hospitals, and qualitative analysis was conducted. The results revealed the following four categories: [Identifying lifestyle goals related to “mobility” based on the patient’s life before hospitalization and his/her current situation], [Constantly supporting the identification of appropriate exercises for “mobility”], [Respecting the patient’s own independent “mobility”], and [Creating an environment for continued support to promote “mobility”]. The results of this study show how the subjects put these identified categories into practice during the patient’s short hospital stay and thus provide knowledge on nursing skills to promote “mobility” in hospitalized old patients and contribute to the prevention and recovery of functional decline during hospitalization. Because the subjects of this study were certified nurse specialists in gerontological nursing, a future challenge will be to examine how this can be practiced by general nurses and how it can be disseminated.