Ability of older male caregivers to seek help when caring for a wife or mother with dementia living at home.

Objective: We aimed to clarify factors associated with the ability to seek help among older male caregivers who care for women with dementia in their families. Patients and Methods: This information will inform strategies to support their continued provision of long-term care. Participants were 364 male caregivers recruited from three places: The study period was 2017-2018. We obtained ethical approval for this study from the relevant ethics committee. Results: The ability to seek help for care problems among male caregivers was normally distributed. We found that more than 90% of older male caregivers did not actively seek help to resolve care problems, suggesting that older male caregivers had problems with long-term care. In the high score group, health status and the number of emotional support persons in the household were significantly and somewhat strongly positively correlated. The low score group showed a significant and rather weak positive correlation between economic status and health status, and the number of emotional supporters inside and outside the household. Positive correlations for the high score group were self-esteem and depressive symptoms, and self-esteem and resources. Positive correlations for the low score group were self-esteem and depressive symptoms, self-esteem and resources, and resources and depressive symptoms. Conclusion: Male caregivers are more likely to seek help if they are employed or play a role in their community. Nurses also need to support male caregivers with positive words and praise to help them use available support and resources and continue to provide long-term care. It is important for healthcare professionals to observe whether a caregiver presents with depressive symptoms or has long-term care problems because older male caregivers do not seek help. Collaboration between caregivers and medical, long-term care, and welfare professionals is necessary. Direct and timely intervention is needed.

The effects of yoga and mindful meditation on elderly care worker's burnout: a CONSORT-compliant randomized controlled trial.

Objectives: This study aims to investigate the effects of mindful meditation and yoga on reducing burnout and stress in care workers who assist elderly individuals. Knowing how to reduce burnout is important because that of care workers is associated with the quality of client care, worker productivity, and job turnover. Patients and Methods: The participants included 44 care workers who worked for elderly care facilities in rural Fukuoka. They were randomly assigned to one of three intervention groups: control, yoga, or mindfulness. In the yoga intervention group, a certified yoga instructor taught a 60-minute yoga session each week for six weeks. In the mindfulness group, an experienced medical doctor instructed a mindful meditation program for the same length. Participants were asked to complete the Japanese Burnout Scale (JBS), and the research team collected the level of α-amylase in saliva using NIPRO: T-110-N pre- and post-interventions. Results: MANOVA was performed with each intervention (control, yoga, mindfulness) as the independent variable on the three subscales of the JBS (emotional exhaustion, depersonalization, and personal achievement) and a biomarker of stress level (α-amylase). The results indicated a significant main effect of interventions, and a follow-up ANOVA showed a significant effect of interventions on emotional exhaustion and personal achievement. Conclusion: The results indicate that practicing mindful meditation or yoga for 60 minutes once a week for six weeks can reduce care workers' burnout. This study was notable because the biomarker of stress also improved. It is strongly recommended and encouraged that institutions caring for the elderly population provide mindful meditation or yoga intervention to reduce burnout, which benefits not only care workers but also their clients.

Daily step counts and health-related quality of life before and after bilateral and unilateral total hip arthroplasty.

Purpose: We examined and compared the daily step counts and health-related quality of life of patients before undergoing either bilateral or unilateral (with or without arthritis in the opposite joint) total hip arthroplasty (THA), and for 6 months afterwards. Participants and Methods: Participants were patients who were living at home and were requested to wear accelerometers and log their daily step count preoperatively and again 6 months postoperatively. Additionally, they completed the Oxford Hip Score and EuroQol 5-Dimension questionnaires at both time points. Results: Data from 40 patients were analyzed. Patients underwent bilateral total hip arthroplasty (n=13), unilateral total hip arthroplasty with arthritis in the opposite joint (n=13), and unilateral total hip arthroplasty without arthritis in the opposite joint (n=14). The Oxford Hip Score and EuroQol 5-Dimension score showed that the daily step counts of patients who underwent bilateral or unilateral total hip arthroplasty without arthritis in the opposite joint significantly increased postoperatively, but that of patients who received unilateral THA with arthritis in the opposite joint did not change significantly. The Oxford Hip Score indicated an improvement in hip joint function after surgery, but the EuroQol 5-Dimension score did not show a significant change postoperatively in patients who received bilateral total hip arthroplasty. Conclusion: The pre- and postoperative comparisons of the participant's daily step count after bilateral and unilateral operations without arthritis on the other side showed improvements in their amount of daily life activities. In all surgeries, Oxford Hip Score improvements were confirmed. The EuroQol 5-Dimension score of bilateral operations did not change. Bilateral operations and an understanding of unilateral postoperative qualitative support will be necessary in the future.

The mediating effect of resilience between family functioning and mental well-being in hemodialysis patients in Japan: a cross-sectional design.

BACKGROUND: End-stage kidney disease is highly prevalent worldwide. Currently, one of the most effective treatment modalities is dialysis therapy, which leads to serious side effects. Furthermore, psychiatric illnesses are prevalent among dialysis patients. Recently, researchers asserted that psychological resilience and family support could be helpful to maintain or improve patients' mental well-being. Therefore, the purpose of this study was to examine the mediating effects of resilience on the relationship between family functioning and mental well-being in these patients. METHODS: To investigate the aim of this study, a cross-sectional design was employed. A total of 110 hemodialysis patients, who were receiving outpatient treatment from dialysis units at the University of Fukuoka and St. Maria Health Care Center in Japan, participated. Only the patients who met the criteria and who were willing to participate in this 30-min study were given The General Health Questionnaire-12, Conner-Davidson Resilience Scale, and Family Assessment Device. Structural Equation Modeling (SEM) was performed to test the hypothesis that resilience would mediate the relationship between each subscale of family functioning, namely, cohesion, adaptability, communication, and mental well-being. Then Sobel's test was employed to examine the indirect effect. RESULTS: The results of the SEM showed that the model had an acceptable fit (RMSEA = .077; CFI = .93; and IFI = .94). According to the results, resilience fully mediated the relationship between family functioning, specifically family adaptability and communication, and mental health well-being of the dialysis patients. However, family cohesion was not associated with resilience. CONCLUSIONS: The present study revealed that higher family adaptability and communication resulted in greater resilience, thus associated with better mental health. Given that poor mental health among dialysis patients is significantly associated with a decreased likelihood to adhere to treatment plans, it may lead to a significant risk to therapeutic compliance. As such, patients may experience detrimental consequences, such as death. This study showed that in order to maintain healthy mental well-being, developing resilience is a vital factor for hemodialysis patients.

The Mediating Effects of Resilience, Morale, and Sense of Coherence Between Physical Activity and Perceived Physical/Mental Health Among Japanese Community-Dwelling Older Adults: A Cross-Sectional Study.

The aim of this study was to examine the mediating effects of resilience, morale, and sense of coherence on the relationship between physical activity and respondents' perceived physical/mental health and depression among community-dwelling older adults in Japan. The study included 369 participants with an average age of 74 years from Kasuishimohara District in Fukuoka Prefecture, Japan. They completed a survey that included the Resilience Scale, the Sense of Coherence Scale, the Medical Outcomes Short Form 8, the Philadelphia Geriatric Center Morale Scale, the Geriatric Depression Scale (Short Form), and a demographic questionnaire. The results of the path mediation analyses revealed that resilience and morale fully mediated the relationship between physical activity and perceived physical/mental health and depression. However, sense of coherence was not a significant mediator. Some intervention programs are suggested to maximize the effects of physical activity on one's well-being. At-risk populations who need such programs are also discussed.

Trauma, depression, and resilience of earthquake/tsunami/nuclear disaster survivors of Hirono, Fukushima, Japan.

AIM: A mega-earthquake and tsunami struck the northeastern coast of Japan, and many survivors were forced to evacuate to temporary housing due to rising radiation levels. The aims of this study were to investigate the prevalence of symptoms of post-traumatic stress disorder (PTSD), depression, and poor general health among survivors, to test the predictive roles of resilience on mental and physical health, and to examine the predictive sociodemographic factors on resilience. METHODS: Two hundred and forty-one evacuees (men/women: 116/125) from Hirono, Fukushima participated in the study. They were asked to complete the Connor-Davidson Resilience Scale, the Zung Self-Rating Depression Scale, the Impact of Events Scale-Revised, and a demographic questionnaire. RESULTS: Among all participants, 53.5% exhibited the clinically concerning symptoms of PTSD, and among them 33.2% indicated clinical PTSD symptoms. Additionally, 66.8% reported symptoms of depression, and among them 33.2% showed mildly depressive symptoms, while 19.1% and 14.5% demonstrated moderate and severe depressive symptoms, respectively. Resilience was a significant buffer for depression, PTSD, and general health. Additionally, employment status, eating/exercise habits, and drinking habits predicted resilience. CONCLUSION: The results indicated that depression and PTSD are prevalent among the survivors of massive earthquakes, tsunamis, and accidents from nuclear power plants. However, the results also showed that some survivors managed to endure the traumatic events relatively well, and resilience was a significant protective factor in dealing with such events. Therefore, it is crucial to assist survivors in improving their resilience by providing job opportunities and encouraging a healthy lifestyle.

Effect of an extract of Ganoderma lucidum in men with lower urinary tract symptoms: a double-blind, placebo-controlled randomized and dose-ranging study.

AIM: To conduct a double-blind, placebo-controlled randomized and dose-ranging study to evaluate the safety and efficacy of the extract of Ganoderma lucidum (G. lucidum) in men with lower urinary tract symptoms (LUTS). METHODS: We enrolled male volunteers (> or = 50 years) with an International Prostate Symptom Score (IPSS; questions 1-7) > or = 5 and a prostate-specific antigen (PSA) value < 4 ng/mL. Volunteers were randomized into groups of placebo (n = 12), G. lucidum of 0.6 mg (n = 12), 6 mg (n = 12) or 60 mg (n = 14), administered once daily. Efficacy was measured as a change from baseline in IPSS and the peak urine flow rate (Q(max)). Prostate volume and residual urine were estimated by ultrasonography, and blood tests, including PSA levels, were measured at baseline and at the end of the treatment. RESULTS: The overall administration was well tolerated, with no major adverse effects. Statistical significances in the magnitude of changes between the experimental groups were observed at weeks 4 and 8. No changes were observed with respect to Q(max), residual urine, prostate volume or PSA levels. CONCLUSION: The extract of G. lucidum was well tolerated and an improvement in IPSS was observed. The recommended dose of the extract of G. lucidum is 6 mg in men with LUTS.