Aim
This study aimed to develop a patient‐centred handbook that integrates information on lifestyle modifications and psychological support strategies for individuals with mild cognitive impairment ...(MCI). This article provides a comprehensive record of the development process.
Methods
We adopted a participatory research model for the methodology, which comprised five phases and involved an interdisciplinary team specializing in dementia and health literacy. Data were initially collected via interviews conducted among patients with MCI (n = 5) and their families (n = 5). Given the study's preliminary nature, depth and richness of the qualitative data were the key concerns for determining the sample size, rather than broad generalizability. We ensured the inclusion of diverse experiences and perspectives by facilitating the creation of patient questions (PQs) that merged scientific evidence with patient perspectives. To enhance the handbook's accessibility and utility, we continuously evaluated the same using patient interviews, health literacy tool assessments and team discussions. This comprehensive approach harmonized scientific knowledge and patient experience, leading to the development of a personalized MCI management guide.
Results
The handbook comprises nine domains, encompassing 38 selected PQs: MCI, lifestyle, lifestyle‐related diseases, exercise, nutrition, social participation, cognitive training, psychological care and family support. The health literacy handbook was evaluated based on Clear Communication Index scores. The results revealed that 73.7% of the PQs were deemed difficult prerevision, whereas only 5.3% remained challenging postrevision. The formative evaluation underscored the need for more detailed explanations prerevision, whereas postrevision comments focused primarily on editorial suggestions.
Conclusion
The inclusion of patients' perspectives right from the outset ensured that the handbook met their specific needs. The final version, which reflects all stakeholders' inputs, is now slated for imminent publication.
Patient or Public Contribution
Patients and the public participated extensively throughout the project, from initial interviews to material evaluation and refinement.
Aim
The aim of this study was to examine the ability of a group‐based multi‐component psycho‐educational intervention (GMC‐PEI) to reduce depression, and improve caregiving appraisals, coping skills ...of informal caregivers and the condition of people with dementia.
Methods
In this randomized controlled and blinded trial, we enrolled 54 informal caregivers of people with dementia visiting the Japan National Center of Geriatrics and Gerontology, and divided them into GMC‐PEI and control groups. The intervention group received a 12‐week GMC‐PEI program that included six 2‐h structured sessions to enhance their knowledge of dementia, caregiving skills and coping skills. The control group received leaflets containing information about dementia. We evaluated caregivers' depression, caregiving time, subjective burden, caregiving appraisal and care coping skills. We also evaluated people with dementia at baseline and 12 weeks, and reassessed 20 participants from the intervention group at 24 and 48 weeks.
Results
The GMC‐PEI significantly improved depression, positive appraisals of fulfillment in caregiving, affection for care recipients, self‐growth and coping skills, such as seeking formal support. Depression, fulfillment and affection for people with dementia showed a peak improvement at 24 weeks; formal support‐seeking showed a linear improvement throughout the 48‐week follow‐up period.
Conclusions
The group‐based multi‐component psycho‐educational intervention reduced depression, improved self‐appraisal and enhanced coping skills in caregivers. However, emotional enhancements dissipated sooner than support‐seeking skills, suggesting that caregivers should be reviewed every 12–24 weeks. Geriatr Gerontol Int 2021; 21: 561–567.
As individuals are susceptible to social influences from those to whom they are connected, structures of social networks have been an important research subject in social sciences. However, ...quantifying these structures in real life has been comparatively more difficult. One reason is data collection methods—how to assess elusive social contacts (e.g., unintended brief contacts in a coffee room); however, recent studies have overcome this difficulty using wearable devices. Another reason relates to the multi-layered nature of social relations—individuals are often embedded in multiple networks that are overlapping and complicatedly interwoven. A novel method to disentangle such complexity is needed. Here, we propose a new method to detect multiple latent subnetworks behind interpersonal contacts. We collected data of proximities among residents in a Japanese farming community for 7 months using wearable devices which detect other devices nearby via Bluetooth communication. We performed non-negative matrix factorization (NMF) on the proximity log sequences and extracted five latent subnetworks. One of the subnetworks represented social relations regarding farming activities, and another subnetwork captured the patterns of social contacts taking place in a community hall, which played the role of a “hub” of diverse residents within the community. We also found that the eigenvector centrality score in the farming-related network was positively associated with self-reported pro-community attitude, while the centrality score regarding the community hall was associated with increased self-reported health.
This paper discusses what well-being means to caregivers and how it can be measured to confirm its acquisition by using previous research on theoretical and practical aspects.Within the field of ...psychology, the two types of well-being (subjective and psychological well-being) are combined to form "feeling good and functioning well", which refers to "pleasant subjective experiences, meaningful activities and the realization of human potential in an individual's life".On the other hands, a review study reported on the Global Measure of well-being, that is, depressive symptoms, mental health, QOL, satisfaction with life and health, also on caregiver-specific well-being measures that are burden, role strain, personal strain, stress, competence and self-efficacy. The majority of measures focused on the negative aspects of well-being.If there is no simple measurement tool that captures both the positive and negative aspects of well-being, a comprehensive and quantitative evaluation of dementia care, so for the present there is no alternative but to using multiple tools for evaluation.The Eco-map of the Ecological Social Work method, which was used in a psycho-educational intervention for caregivers, was shown to provide a hint as to how to take a macroscopic and comprehensive view of dementia care and how to easily grasp an understanding of the well-being of caregivers.
Ethyl 12-oxo-4,11-dihydro-4,11-ethanonaphth2,3-fisoind ole-1-carboxylate (2) was prepared from 7-tert-butoxynorbornadiene and quantitatively converted to ethyl naphth2,3-fisoindole-1-carboxylate (3) ...by the thermal or photochemical cheletropic reaction. Ethyl naphth2,3-fisoindole-1-carboxylate (3) existed in a 2H-form both in solution and as a solid, and gradually dimerized to give a dianthradiazafulvalene derivative under aerobic conditions.
本稿では，介護者のwell-beingとは何か，またwell-beingの獲得を確認する方法とはどのようなものか，理論と実践，二側面の先行研究を用いて考察した．well-beingとは何かについての回答は，立場によって大きく異なる．哲学的側面では，“amounts to the notion of how well a person's life is going for that ...person”という概念に相当するとされている．しかし，正確さに欠ける懸念もあり，well-beingを定義する際には，定義のStrategy（分析対象・議論領域・定義の方向性），subjective well-beingかpsychological well-beingかのスタンスを検討する必要性がある．そして，心理学領域から，“feeling good and functioning well”“個人の人生における快い主観的な経験，意味・意義のある活動，人間としての可能性を実現する社会的な関係から成る複合的な概念”という定義がなされている．これらの定義の根底にあるのはthe whole human pictureを捉える重要性である．さらに発展させた形態としてWell-beingの構成要素がPERMA（Positive Emotion，Engagement，Relationships，Meaning，Accomplishment）という仮説的定義があり，この構成要素がwell-beingの予測因子になりうるか研究が進められている．一方，介護領域の介入試験のアウトカムで用いた既存尺度の探索Review研究では，1．Global Measure of well-being（Depressive Symptoms・Mental health・QOL・Satisfaction with life・Health），2．Caregiver-Specific Well-being measures（Burden・Role strain・Personal strain/Stress・Competence/self-efficacy）に大別された．そしてDepression，Burdenなどwell-beingのnegativeな側面に焦点化した測定が大半を占めた．この結果は，従来の疾病管理的側面の体験により，Patho-genesis的な志向（健康にとって望ましくない要素・問題を除去し改善することが善）への親和性を示している．認知症介護を巨視的，包括的に捉え，介護者のWell-beingを定量的に評価する簡便な測定ツールが無いとするならば，当面は，複数のツールで評価せざるをえない．測定する内容（種別・項目）を増やすことは，測定対象者（介護者）のQOLを著しく下げることになりかねない．認知症介護を巨視的，包括的に捉え，介護者のwell-being状態を簡便に把握するにはどのようにすればいいのか，その解として，介護者向け心理教育的介入試験で実施したSocial Work手法のEco-mapにヒントがあることを示した．
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