Dynamics of Interaction among Professionals, Informal Supporters, and Family Caregivers of People with Dementia along the Dementia Care Pathway: A Nationwide Survey in Japan.

This study aims to clarify the dynamics of information provision and human interaction to satisfy the needs of family caregivers. A questionnaire survey consisting of items on information received at and after diagnosis, persons and resources consulted, needs, and caregiver-oriented outcomes was conducted. Among the respondents, 2295 individuals who were caring for people with dementia were divided into quartiles by the time after diagnosis, and differences were statistically analyzed. The time after diagnosis in the first to fourth quartiles was 0.73 ± 0.4, 2.52 ± 0.49, 4.89 ± 0.73, and 10.82 ± 3.7 years, respectively. The number of persons consulted by family caregivers increased significantly from the first to the fourth quartiles (p < 0.001). During this time, attributes of professionals and informal supporters changed depending on the quartile. As time progressed, acceptance of the diagnosis increased, but so did its impact on the lives of family caregivers. These findings revealed differences over time in what family caregivers wanted and the dynamics of interactions that filled their needs. Informal supporters accounted for a significant proportion of the total resources. However, many family caregivers thought the information and support were insufficient. Thus, continuous reform of the care pathway is needed.

[The effect of videophone system for diabetic homecare patients on glycemic control].

It is imperative to develop a novel care approach and low-cost health care system for diabetic patients.Therefore, we conducted an intervention study to clarify how effectively a videophone system could be used in the life style guidance focusing on diet for the diabetic patients cared at home.For the period of 3 months, diabetic patients were communicated with a medical professional staff bi-directionally through a videophone-based communication system for 30 minutes once a week.During the 30-minute intervention, the medical staff checked the list with the change in weight, drug adherence and an exercise habit.We encouraged a diabetic patient to eat properly based on the diet record.The 3-month intervention program resulted in a significant decrease in BW(p<0.001 ), BMI(p<0.001 ), and the average HbA1c level(p<0.005 ).In conclusion, we showed a 3-month intensive communication result using a multimodal videophone system, which revealed a significant decrease in the body weight, BMI and the average HbA1c level.This once a week ICT communication might be useful as an auxiliary therapy to help change a bad daily habit to a good daily habit for a diabetic homecare patient.

[The Support System for Diabetic Patients at Home with Bi-Directional IT Communication].

The present study analyzed the effects of bi-directional IT communication on the purpose of preventing diabetes progression and to reduce a caregiver burden. Diabetic patients were informed of the nature and purpose of the study before giving their voluntary consents to participate in the study. For the period of 12 weeks, a diabetic patient and his caregiver were communicated with a nurse through the TV telephone for 30 minutes once a week. Medical staff checked the list of weight change, compliance check, exercise habit, and attached pictures of the plate with a diabetic patient through the TV telephone in real time. We encouraged a diabetic patient to eat properly based on the diet record. The 12-week TV telephone communication resulted in the body weight decrease and HbA1c. There was a consciousness change about their daily eating habit. In the present study, the 12-week TV telephone communication once a week might be useful as an auxiliary therapy for changing a bad daily habit to a good daily habit for a diabetic patient at home.