[Factors related to the subjective well-being of elderly residents of special nursing homes].

PURPOSE: This study assessed the subjective well-being of elderly residents of special nursing homes, and examined related factors, particularly from the perspective of lifestyle. METHODS: An interview survey using a structured questionnaire was conducted on 124 elderly individuals (age, > or =65 years) living in one of 8 special nursing homes in 2 prefectures in the Hokuriku region for at least 3 months. All were graded as level II or less on the Dementia Elderly Daily Living Independence Rank from late August to early November 2002. A total of 115 subjects (men, n=26; women, n=89; mean age, 83.16 +/- 7.13 years) were included in the analysis. Regarding survey items, the residents' subjective well-being was measured using the revised PGC Morale Scale, and related factors were categorized into "basic attributes", "activities of daily living", "health", "personal relationships within the facility", and "freedom in lifestyle". RESULTS: The mean PGC Morale Scale score was 10.06 +/- 3.95 points. As a result of multiple regression analysis, factors related to the subjective well-being of elderly residents of special nursing homes were found to be: "sense of freedom of choice in lifestyle", "feeling of seeing the staff smile", "no worrisome disease", "lack of physical pain", and "absence of renal disease and urinary organ disease". CONCLUSION: Security, human relations being good, an acceptable physical state of health, a degree of freedom in everyday life were found to underly a subjective feeling of happiness in persons living in welfare institutions. It is therefore important that these be taken into account in free choice of a care service, with emphasis on providing a desirable residence environment with good human relations inwelfare institutions.

Chronic interstitial pneumonia in silicosis and mix-dust pneumoconiosis: its prevalence and comparison of CT findings with idiopathic pulmonary fibrosis.

BACKGROUND: Increased prevalence of chronic interstitial pneumonia (CIP) is reported in dust-exposed subjects. We investigated the prevalence of CIP in silicosis and mixed-dust pneumoconiosis and sought morphologic differences of CIP between the pneumoconiosis and idiopathic pulmonary fibrosis (IPF). METHODS: We reviewed CT scans of 243 silicosis and mixed-dust pneumoconiosis patients to identify any cases of parenchymal lung lesions showing a CIP pattern, and compared the CT findings with those of 62 patients with IPF. Two observers independently scored CT images and classified the CT pattern as typical or not typical for IPF. Differences were sought between the groups using a nonparametric test, Fisher exact test, and a logistic regression analysis. A radiopathologic correlation was performed in 11 pneumoconiosis patients. RESULTS: Twenty-eight patients (11.5%) showed CIP on CT. Seven patients (25%) showed a pattern not typical of IPF, while the remaining patients showed a pattern typical of IPF, 11 of which were confirmed pathologically. The extent of fibrosis did not differ between the groups; however, patients with pneumoconiosis showed less traction bronchiectasis (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.08 to 0.48; p < 0.001), more subpleural homogeneous attenuation (OR, 2.56; 95% CI, 1.55 to 4.23; p < 0.001), and fibrosis was more randomly distributed (OR, 315.38; 95% CI, 4.68 to 21244.63; p = 0.007). Pathologically, subpleural homogeneous attenuation corresponded to dense fibrosis often with abundant silicotic nodules. CONCLUSIONS: Prevalence of CIP in pneumoconiosis was approximately 12% on CT. One fourth of patients showed an atypical IPF pattern, and the others showed a typical IPF pattern.