Purpose: This systematic review aimed to explain whether improving family caregivers’ understanding of behavioral management and coping mechanisms for behavioral and psychological symptoms of dementia (BPSD) is effective.

Methods: We conducted a systematic review to evaluate the efficacy of improving the understanding regarding behavioral management among family caregivers of people with dementia (PWD). The articles were selected and screened based on the following criteria: (1) randomized controlled trial; (2) family caregivers of PWD as research targets; and (3) intervention content including professional support to improve family caregivers’ understanding of behavioral management and coping with BPSD.

Results: Eight articles met the inclusion criteria. In the intervention group, reductions in caregiving burden, alleviation of depression, improvements in caregiver well-being, enhancements of caregiver skills, amelioration of BPSD, and overall enhancement of caregivers’ quality of life were observed.

Conclusion: Despite limited evidence supporting the results, professional intervention is effective in promoting family caregivers’ understanding of BPSD among older adults living in their own homes.

The purpose of this study was to examine the utility of fieldwork on smaller islands as part of recurrent education for nursing professionals. Recurrent education was implemented as part of a program subsidized by the Japanese Ministry of Education, Culture,Sports,Science and Technology with the goal of developing nursing professionals able to support living in the community to the end of life.

We conducted a qualitative analysis of the post-fieldwork learning reports written by 48 clinically experienced nurses who had completed the program.

As a result,program participants recognized “dignified living that shapes the individual” and “understanding and respect for a life unable to be measured by one’s own pre-existing knowledge and experience” by placing themselves in the unique island environment including “a prosperous life without disadvantages in health and welfare conditions” and “communities to coexist in an area created by its unique culture”, and they developed new schema such as “the importance of viewing the patient as an indivichal living in the community” and “the importance of cooperation and collaboration throughout the community to support the individual’s unique lifestyle”, which led them to “rethinking identity as a nursing professional”.

In other words, the results suggest that the smaller island fieldwork did have utility for relearning nursing with holistic perspective.

This study identified the most cost-effective pattern of long-term care (LTC) services for older individuals newly certified as eligible for LTC insurance benefits by municipalities.We followed 1,567 older individuals who were newly certified as requiring support using the five-year medical and LTC claims data, and categorized service use within one year of being newly certified as requiring support. To measure the pattern of LTC service use within one year of new certification, most effective in reducing the burden of disability-adjusted life years (DALYs) and a cost-effectiveness analysis was conducted. In a cost-effectiveness analysis, the costs were defined as the insurance expenditures over five years, and the effects were defined as DALYs. During the cost-effectiveness analysis, bootstrap simulations were performed to evaluate reliability. We categorized LTC service use into four patterns: [a] low-use, [b] adult day service for disability prevention (ADS-DP), [c] personal assistance for disability prevention, and [d] mixed-use. After five years, the mean DALYs of the ADS-DP pattern was 1.97 years. The cost-effectiveness acceptability probability was 0.49 for the five-year willingness to pay (WTP) for total LTC insurance expenditures of 7.74 million Yen. As WTP further increased, the probability also increased and was higher for the other patterns. Thus, the ADS-DP pattern was the most cost-effective. Cost-effectiveness analysis becomes increasingly important in LTC insurance because of evidence based policymaking. The use of the ADS-DP pattern services during the new certification of requiring support was found to reduce DALYs among older individuals at a low cost.

[Aim] This study investigated the type of educational needs that nursing managers at home-visit nursing stations deem necessary to develop a “Simulation Educational Program at the Home-Visit Nursing Station” (hereinafter, “educational program”), and examined the possibility of holding the educational program.

[Methods] Out of 14 Foundation A home nursing centers in Region B, 7 nursing managers who provided consent were included in the study. We conducted online interviews, lasting approximately 90 minutes, on educational needs in simulation education and the structure of the educational program. We referred to an interview guide and the items of the “Learning Needs Assessment Tool for Visiting Nurses” and “Educational Needs Assessment Tool for Visiting Nurses.” The interview data were transcribed and analyzed by a quantitative text analysis method using KH Coder3.

[Results] In total, 28,160 words were extracted. Co-occurrence network diagram analysis was performed on words with 10 or more occurrences. The results were classified into 11 word clusters, including “physical assessment,” “collaboration and communication with other (multi)professions,” “communication,” and “experience that newcomers have.” The respondents also indicated that the educational program can be implemented at their own facilities if it is no longer than 90 minutes.

[Conclusions] Based on the educational needs identified by the co-occurrence network, we found that the educational program is highly compatible with the implementation of situation-based and inter-occupation collaborative simulations. Further, the possibility of holding educational programs can be increased by making the educational programs directly and itinerantly delivery to their workplace.

Many severely ill persons use home-visit bathing care, and nurses who provide home care are required to decide whether to bathe them as part of their tasks. However, nurses are anxious about providing home-visit bathing care because few educational opportunities are available about home-visit bathing. We conducted a questionnaire survey to clarify the situation regarding providing medical care with home-visit bathing and the educational needs of nurses who provide home-visit bathing.

The results showed that home-visit bathing care often involves medical care such as treatment of bedsores and administration of drugs. Most nurses engaged in such care were anxious about performing these duties, and many of them stated that they needed education on physical assessment and risk handling. Anxiety was associated with a perceived need for education (p<0.007), and a self-reported lack of knowledge (p<0.001) and skills (p<0.012). Therefore, providing nurses with knowledge and skills related to home-visit bathing may reduce their anxiety. Educational programs that consider the role of nurses in home-visit bathing care need to be developed.

Objective: This study examined the differences in perceptions of social interactions between frail older adults living on remote islands who have many interpersonal contacts and those who have few such contacts. Further, it aimed to investigate and gain deeper insights into long-term care prevention activities.

Methods: Using the Japanese version of the shortened Lubben Social Network Scale (0-30 points), we conducted a survey with 94 respondents. Based on the results, four individuals with 20 or more points (high-contact group) and seven individuals with 11 or fewer points (low-contact group) were selected for follow-up semi-structured interviews.

Results: In the high-contact group, the themes of “joy of interacting with close contacts,” “mutual consideration with contacts,” and “gratitude towards contacts” were extracted. In the low-contact group, the themes of “loneliness and sense of crisis living in a declining community,” “difficulty in mutual understanding with others,” and “gratitude towards others” were extracted.

Discussion: Although the perceptions of social interactions differed between the high- and low-contact groups, “gratitude towards others” was a common theme in both groups. For long-term care prevention activities, the number of social interactions should be increased to prevent the transition from loneliness to isolation.