Development of a Measure to Evaluate the Quality of Dementia Care Provided by Caregivers at Unit Care Geriatric Health Service Facilities

This study was conducted to develop a measure for evaluating the quality of dementia care provided by caregivers in unit care geriatric health service facilities in Japan. A secondary factor model consisting of the following factors was used in the study. Primary factors were: "Creating a safe environment with a home-like atmosphere," "Helping residents maintain their ordinary life," "Helping maintain and improve the lifestyles of individual residents," "Providing support in a way that respects each resident\u27s unique personality," "Encouraging social interaction with others" and "Maintaining family relationships," and one secondary factor, "Quality of dementia care." The construct validity of the above measure was assessed in terms of the relationship between the factor model and an external criterion using structural equation modeling (SEM) based on data from 984 caregivers. Job satisfaction was used as the external criterion. As a result, the fit of the factor model to the data and the relationship between dementia care quality and job satisfaction were statistically supported. The Cronbach alpha coefficient for the measure was within statistically permissible limits. Based on the above results, we concluded that the measure to evaluate dementia care quality that was developed in the study is effective for evaluating the quality of dementia care provided by caregivers in unit care geriatric health service facilities

Relationships between Dementia Care Duties and the Job Satisfaction of Nursing Staff in Unit-type Geriatric Health Service Facilities

This study examined the relationship between the frequency of high-quality dementia care duties and job satisfaction among nursing employees working in unit care geriatric health service facilities, including the perceived difficulty of performing care and responses to difficult work situations. Self-administered questionnaires were distributed to a total of 608 subjects. 324 effective responses were received and analyzed. A causal model was proposed in which the frequency of high-quality dementia care is influenced by the perceived difficulty of practicing such care, and that these two factors, mediated by control and escapes responses, affect job performance. Structural equation modeling was employed for assessment of fit and to evaluate the relationships between variables. After confirming that the proposed model fitted the data, it was found that high-quality dementia care is indeed associated with the perceived difficulty of practicing such care and that these two factors, mediated by control responses, are associated with job satisfaction. The results indicate that sustaining and increasing job satisfaction requires adopting control-oriented responses and improving the quality of dementia care

Relationships between Spirituality, Health Self-efficacy and Health Locus of Control in the Elderly

The purpose of this study was to clarify the relationships between spirituality, health locus of control and health self-efficacy. A questionnaire survey was administered to elderly people living at home, and 696 valid responses were collected and analyzed. The subjects\u27 mean age was 74.0±5.2 years. Using a causal model to analyze the relationship between spirituality, health locus of control and health self-efficacy, data fitness to the model was evaluated by structural equation modeling. As a result, the validity of a model in which health locus of control affects health self-efficacy and spirituality while health self-efficacy enhances spirituality was confirmed. However, the nature of the relationship between health locus of control and spirituality and health self-efficacy differed according to the characteristics of health locus of control. In addition, there was a positive correlation between health self-efficacy and spirituality regarding "significance and objectives of life", "harmony with others", "belief", and "union with nature". In order to support for the spirituality of the elderly, the author suggests that strategies to improve the health self-efficacy for basic health control behavior are useful

A subjective well-being of the aged - psychological characteristics of elderly people of 90 or older -

高齢化社会の到来に伴い一言で老人といっても幅広い年代が対象となり、一律に老人では説明できない。実際看護をしていると90歳をすぎた老人はその年代迄にはない、穏やかさ、焦りのなさ、人生を達観しているような感じを受けることが多い。そこで90歳以上の老人にみられるイメージや心理面の特徴を明らかにし看護実践の一助としたいと考えた。方法は80歳以上の入院患者50名に身体、生活、家族面からみた現状、他者から見たイメージ、主観的幸福感を調査した。その結果、90歳以上は80歳代にくらべ看護者に肯定的イメージに受け取られる傾向にあった。主観的幸福感を示すモラール得点の総合点では差はなかったが得点する内容に差が見られ、80歳は積極的な生き方で得点しているものが多く90歳代は現状に満足している点で得点している者が多かった。看護者からみたイメージと本人の主観的幸福感は両年代とも肯定的イメージで相関した。The population of the aged is currently increasing with advanced medical science and technology. The aged have become to keep their lives long. In this paper, We especially focused on their psychological characteristics of elderly people of 90 and older to offer high quality of nursing care for them. We interviewed 50 patients of 80 years and older about a subjective well-being, using a questionaire based on Philadelphia Geriatric Center Morale Scale. And also we asked 50 nurses, who took care of them exclusively, a questinaire about their images of the aged. We report as follows : 1. The nurses estimated that their images of the second group (range : 90 years old ~) were better than the first group (range : 80~89 years old). 2. In subjective well-being which Philadelphia Geriatric Center Morale Scale showed, above-mentioned both groups were similar in total scores. However, each item was marked differently by them. 3. In both groups, their subjective well-being correlated with good images for them