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Objective: Palliative care for dementia includes psychosocial interventions as first-line treatment for challenging behaviour. However, the national dementia plan in Japan contradicts recommendations for palliative care for dementia. This study aimed to examine the association between care quality for patients with dementia and professional caregivers' perspectives regarding palliative care for dementia in Japanese community care settings.Methods: In total, 2116 professional caregivers from 329 agencies (217 in-home long-term care support providers; 29 small-scale, multiple home-care providers; and 83 group homes) in Tokyo prefecture, Japan, completed cross-sectional, paper-based questionnaires about 3603 people diagnosed with dementia, in May 2016. Quality of care measures included physical restraint and antipsychotic medication use and quality of life. Patients' quality of life was assessed via the Japanese version of the Alzheimer's Disease Health-related Quality of Life scale. The Japanese version of the Questionnaire on Palliative Care for Advanced Dementia was used to assess professional caregivers' knowledge and attitudes regarding palliative care for dementia.Results: Professional caregivers' knowledge and attitudes regarding palliative care for dementia were positively associated with quality of life in patients with dementia. Physical restraint and antipsychotic medication were used regardless of professional caregivers' knowledge and attitudes.Conclusions: Professional caregivers' perspectives regarding palliative care for dementia could have exerted a positive effect on quality of life in patients with dementia. A national strategy for advocacy and the protection of adults is required to integrate several laws and guidelines and prevent the use of antipsychotics as a form of chemical restraint. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim: To explore the unclear association between temporary discharge home from the palliative care unit and achievement of good death, in the background of increases in discharge from the palliative care unit. Association between experiences and circumstances of patient and family and duration of temporary discharge was also examined. Methods: This study was a secondary analysis of data from a nationwide post‐bereavement survey. Results: Among 571 patients, 16% experienced temporary discharge home from the palliative care unit. The total good death inventory score (p <.05) and sum of 10 core attributes (p <.05) were significantly higher in the temporarily discharged and stayed home ≥2 weeks group. Among all attributes, "Independent in daily activities" (p <.001) was significantly better in the temporarily discharged and stayed home ≥2 weeks group. Regarding the experience and circumstance of patient and family, improvement of patient's appetite (p <.05), and sleep (p <.05) and peacefulness (p <.05) of family caregivers, compared to the patient being hospitalized, were associated with longer stay at home after discharge. Conclusions: Patient's achievement of good death was better in the temporarily discharged and stayed home longer group, but this seemed to be affected by high levels of independence of the patient. Temporary discharge from the palliative care unit and staying home longer was associated with improvement of appetite of patients and better sleep and mental health status of family caregivers. Discharging home from palliative care unit is worth being considered even if it is temporary. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess psychological/psychiatric problems and quality of life (QOL) in patients with thalidomide embryopathy (TE), with a specific focus on pain, including pain severity and the effects of coping strategies for pain. Methods: A questionnaire survey was conducted to evaluate the severity of pain experienced by patients with TE, pain management strategies, time perspective, mental health status, and QOL. Of 67 patients with TE who underwent a health checkup, 51 respondents who gave valid responses were included in analysis. Results: GHQ‐28 suggested that 41.2% of respondents appeared to potentially have psychiatric disorders. The mean scores of QOL were still within a normal range. There is no significant differences were found between limb disability group and hearing impairment group in QOL or mental health status. About 82.4% of respondents reported that they experience physical pain, and the use of the cognitive coping strategy "catastrophizing" to cope with pain was significantly associated with mental health status and QOL. Conclusion: This study demonstrate that although some patients with TE have some form of mental health problem, they still maintain a normal range QOL despite their disabilities. In addition, pain was not as strongly associated with mental health problems and QOL as would be expected, and variables such as "catastrophizing" to cope with pain appear to potentially be associated with reduced mental health and QOL. [ABSTRACT FROM AUTHOR]

Aim: To dentify the predictors of the quality of life (QOL) of infertile men who are undergoing infertility treatments in Japan and to create a QOL prediction model, with the main variables aimed at providing more adequate support to male patients. Methods: This cross‐sectional study used the quantitative data that were collected from 321 returned self‐report questionnaires that had been distributed to the men of 411 couples who were undergoing fertility treatment. The following four scales were used to measure the main outcomes: FertiQoL, psychological distress, spousal support, and workplace support. The data were analyzed by descriptive statistics, multiple regression analyses, and structural equation modeling. Results: The number of returned questionnaires was 321 (78.1%). The QOL that was measured by FertiQoL was significantly lower in those men who were diagnosed with male factor infertility than in the other male patients. The two significant predictors of QOL were: spousal support and the infertility period. The structural equation modeling revealed that the same factors were related to QOL. Conclusions: Male factor infertility, less spousal support, and a longer period of infertility were associated with a poorer QOL of those men who were undergoing infertility treatment. These results suggest that focusing on infertility causes, the length of the infertility period, and the couples' partnership during treatment is needed to provide full support to men who have been diagnosed with infertility. [ABSTRACT FROM AUTHOR]

Aim: To promote preventive care among older individuals dwelling on an isolated, doctor‐less island, we investigated the feasibility and the efficacy of a home‐based exercise program, depending on their functional status and health‐related quality of life. Methods: A total of 23 older (mean age 72.6 years) participants were assigned to a home‐based exercise program (intervention group), and 34 older (mean age 74.2 years) participants were assigned to a group without any intervention (control group). The participants of the intervention group attended the exercise program three times a week for 3 months. The exercise program consisted of various exercises involving stretching, muscle strengthening, balance retraining and walking. The physical performance, Functional Independence Measure and Short‐Form 36‐item health survey were used to assess the physical and the mental wellbeing of the participants. Results: There was no significant difference between the changes in physical performance at baseline and post 3 months in both groups. However, the motor and the cognitive Functional Independence Measure scores significantly improved in the intervention group post 3 months. The domains of the Short‐Form 36‐item health survey improved post 3 months; particularly, significant improvement was observed in the physical functions, general health, vitality, mental health and mental component summary. Conclusions: Although an isolated island has several problems to support preventive care services, such as a lack of medical resources and availability of only a few healthcare workers, the present study provides evidence on the feasibility and efficacy of nurse‐led home‐based exercise programs for improving the physical and mental health of the older people dwelling on an isolated, doctor‐less island. Geriatr Gerontol Int 2018; 18: 1313–1317. [ABSTRACT FROM AUTHOR]

Aims: The beneficial effects of assertive community treatment (ACT), which has been widely acclaimed as being successful in several foreign countries, must also be objectively evaluated with respect to the transition from inpatient to community-based mental health treatment in Japan. This was the first study that examined effects of the ACT program in Japan using pre/post design data of the pilot trial of the ACT program in Japan project. Methods: The study included 41 subjects hospitalized at Kohnodai Hospital, National Center of Neurology and Psychiatry between May 2003 and April 2004 for severe mental illness and who met inclusion criteria for entry regarding age, diagnosis, residence, utilization of mental health services, social adjustment, and ability to function in daily activities. All subjects provided informed consent for study participation and were followed for 1 year after hospital discharge. Results: Comparison of the number of days and frequency of inpatient psychiatric hospitalization and frequency of emergency psychiatric visits between the 1-year period before hospitalization and 1-year period after hospital discharge showed a significant decrease in number of days and frequency of hospitalization. Comparison at 1 year after discharge with baseline showed no change in satisfaction with overall quality of life or Brief Psychiatric Rating Scale scores, but the Global Assessment of Functioning score significantly increased, and the antipsychotic dose (chlorpromazine equivalent) significantly decreased. Conclusion: Despite some limitations in methodology and conclusions, this study suggests that ACT enables persons with severe mental illness to live for longer periods in the community, without worsening of symptoms, decreased social function, or deterioration in quality of life. [ABSTRACT FROM AUTHOR]