Development of a nursing care problems coping scale for male caregivers for people with dementia living at home.

OBJECTIVE: The number of male caregivers has increased, but male caregivers face several problems that reduce their quality of life and psychological condition. This study focused on the coping problems of men who care for people with dementia at home. It aimed to develop a coping scale for male caregivers so that they can continue caring for people with dementia at home and improve their own quality of life. The study also aimed to verify the reliability and validity of the scale. PATIENTS/MATERIAL AND METHODS: The subjects were 759 men who care for people with dementia at home. The Care Problems Coping Scale consists of 21 questions based on elements of questions extracted from a pilot study. Additionally, subjects completed three self-administered questionnaires: the Japanese version of the Zarit Caregiver Burden Scale, the Depressive Symptoms and the Self-esteem Emotional Scale, and Rosenberg Self-Esteem Scale. RESULTS: There were 274 valid responses (36.1% response rate). Regarding the answer distribution, each average value of the 21 items ranged from 1.56 to 2.68. The median answer distribution of the 21 items was 39 (SD = 6.6). Five items had a ceiling effect, and two items had a floor effect. The scale stability was about 50%, and Cronbach's α was 0.49. There were significant correlations between the Care Problems Coping Scale and total scores of the Japanese version of the Zarit Caregiver Burden Scale, the Depressive Symptoms and Self-esteem Emotional Scale, and the Rosenberg Self-Esteem Scale. CONCLUSION: The answers provided on the Care Problems Coping Scale questionnaire indicated that male caregivers experience care problems. In terms of validity, there were significant correlations between the external questionnaires and 19 of the 21 items in this scale. This scale can therefore be used to measure problems with coping for male caregivers who care for people with dementia at home.

Positive appraisal of in-home family caregivers of dementia patients as an influence on the continuation of caregiving.

BACKGROUND: We attempted to determine the factors that influence the continuation of in-home caregiving for patients with dementia. METHODS: The participants were family caregivers of dementia patients who received home care services. Data were collected via a questionnaire completed by caregivers and then returned in the mail. Of the 705 caregivers who received the questionnaire, 405 completed and returned it (response rate: 57.4%). RESULTS: The average age of the caregivers was 63.9 ± 11.5 years, and they had been providing care for an average of 5.1 ± 4.1 years. The average age of the patients was 84.7 ± 7.4 years. We analyzed the path model. Caregivers' current feelings about continuing caregiving were directly affected by a positive appraisal of caregiving (ß = 0.20, P < 0.001) and by the burden they experienced (ß = -0.39, P < 0.001). The continuation of caregiving of patients with worsening symptoms was directly affected by a positive appraisal of caregiving (ß = 0.15, P < 0.01) and by the burden experienced by the caregivers (ß = -0.46, P < 0.001). The continuation of caregiving was indirectly affected by the patients' cognitive impairment and by the behavioral and psychological symptoms of dementia score. CONCLUSIONS: The continuation of in-home caregiving among caregivers of patients with dementia was affected by both positive appraisal and caregiver burden. In addition, the present study revealed that behavioral and psychological symptoms of dementia score indirectly affects the continuation of caregiving by directly affecting caregiver burden.

An international collaborative study comparing Swedish and Japanese nurses' reactions to elder abuse.

AIM: This paper reports an analysis of aggregated data from two national studies on Swedish community-based nurses' and Japanese Public Health Nurses' responses to hypothetical elder abuse cases. BACKGROUND: Elder abuse is an under-researched area despite being globally recognized as a serious and escalating problem. Yet research, adding needed socio-cultural perspectives to current knowledge has been limited. METHODS: Eighty-one community-based nurses in Sweden and 124 Public Health Nurses in Japan responded to a questionnaire based on three hypothetical elder abuse cases. Swedish and Japanese results (data collection 2006-2007) were combined and the aggregated data were analysed using manifest and qualitative content analyses. RESULTS: Nurses' response patterns in the aggregated data were similar across all three hypothetical cases and within themes Awareness, Assessment and Intervention. However, there were also noteworthy differences between Swedish and Japanese responses, e.g. Swedish responses were generally practical, action oriented and involved increased levels of suspicion and personal intervention to achieve increased control; whereas Japanese responses concerned better understanding that involved the family members and their situation, focusing on interventions grounded in collaboration. CONCLUSION: Despite cultural differences, responses of Swedish and Japanese nurses were very similar which points to a global 'humanness' of the problem of, and nurses' responses to, elder abuse. Results endorse the value of international collaborations that give information and inspiration to nursing colleagues across cultural boundaries. Results also give hope that global tools for elder abuse assessment and intervention can be developed.

[Changes in core temperature during snow shoveling among healthy young males in heavy-snowfall area of Chugoku region in Japan].

OBJECTIVES: There are several recommendations on the prevention of hypothermia during snow shoveling. However, there seemed to be insufficient evidence supporting these recommendations because they are not based on data from actual snow shoveling research. The purpose of this study was to investigate changes in brain temperature (tympanic temperature) and visceral temperature (rectal temperature) during snow shoveling among healthy young males. METHODS: Eight healthy young males (age, 23.6 ± 2.4 years; weight, 69.7 ± 6.1 kg; height, 172.8 ± 7.3 cm) performed snow shoveling with an ordinary-size shovel for 15 min at their own pace in a rural snowfall area in December, 2009. Rectal temperature (Tre) and tympanic temperature (Tty) were measured 5 times (at rest, 5th (Ex5), 10th (Ex10), and 15th (Ex15) minute of snow shoveling; and 5th (Rec5) minute of recovery phase). The room temperature was 18.6 ± 0.7°C and the atmospheric temperature was 3.8 ± 2.6°C. RESULTS: Tre continued to increase from at rest to Ex15. Tre at Ex15 (37.7 ± 0.3°C) was significantly higher (p < 0.05) than that at rest (37.2 ± 0.3°C). Tty at rest (36.7 ± 0.2°C) and Tty at Ex5 (36.6 ± 0.3°C) decreased significantly (p < 0.05) at Ex10 (36.2 ± 0.6°C). A significant negative correlation between changes in Tre and Tty were observed during snow shoveling (r = -0.49, p < 0.05). CONCLUSION: Discrepancy between changes in brain temperature (tympanic temperature) and visceral temperature (rectal temperature) should be taken into consideration in the prevention of disease development during snow shoveling in a cold environment.