Kayo Hirooka

Posttraumatic Growth Among Japanese Parentally Bereaved Adolescents A Web-Based Survey

Objective: The aim of this study was to explore the factors associated with posttraumatic growth (PTG) among adolescents bereaved owing to parental cancer in Japan. Methods: An anonymous cross-sectional Web-based survey was conducted, enrolling adolescents bereaved because of parental cancer in the previous 5 years. Posttraumatic growth, number of social support members, support from medical staff, and behaviors after bereavement were measured. Multiple linear regression was performed to explore the association between total PTG score and possible related factors. Results: We assessed 57 participants in this study. Mean age was 19.3 (standard deviation [SD] = 2.0) years, and most participants were female (75.4%). Mean total score of the Japanese version of the PTG inventory was 43.0 (SD = 25.6). Participants’ mean number of social support members was 2.1 (SD = 1.3), and these support members were the surviving parent (66.7%), friends (38.6%), and siblings (36.8%). The multiple linear regression model explained 45% of the variance in PTG. In this model, the following 3 behaviors after bereavement were associated with PTG: “putting palms together in front of a parent’s picture or an altar” (β = .36, P = .006), “visiting a parent’s grave” (β = .29, P = .03), and “having fun with friends” (β = .25, P = .04). Conclusion: Parentally bereaved adolescents in Japan experience PTG. Specific behaviors after bereavements might be recommended for PTG among Japanese adolescents bereaved because of parental cancer.

Dementia behaviour management programme at home : impact of a palliative care approach on care managers and professional caregivers of home care services

ABSTRACT Objectives: Care managers and professional caregivers of home care services are sometimes unaware of the psychosocial approaches to the challenging behaviour of dementia. Therefore, we developed a Behaviour Analytics & Support Enhancement (BASE) programme. We investigated the effects of the programme on the attitudes towards dementia care among professionals. Method: Forty-six participants in Japan received training in August 2016. The ongoing monitoring and assessment system was introduced to the participants for repeated measures of challenging behaviour. A 1-day follow-up meeting for debriefing was also performed after two months. A baseline and follow-up questionnaire survey was administered to the participating caregivers using a Japanese version of the Approaches to Dementia Questionnaire (ADQ) and the Zarit Burden Interview (ZBI). Results: A significant improvement was observed in the total ADQ score among the participating caregivers from baseline to follow-up assessment. There was no significant difference between the baseline and follow-up assessment in the ZBI scores. In the follow-up meeting, several participants reported challenges and suggested solutions in facilitating a discussion on an action plan among professionals from various organizations. Conclusion: The implementation of the programme resulted in enhanced attitudes towards dementia care among the participants without an increased burden of care. Future studies should examine the programmes effectiveness on the challenging behaviour of persons with dementia.

Psychosocial behaviour management programme for home‐dwelling people with dementia: A cluster‐randomized controlled trial

Little is known about the effectiveness of a psychosocial behaviour management programme on home‐dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home‐dwelling people with dementia.

Examining Posttraumatic Growth Among Bereaved Family Members of Patients With Cancer Who Received Palliative Care at Home

Objective: The present study examines the factor structure of the Japanese version of the Posttraumatic Growth Inventory (PTGI-J) among bereaved family members who lost loved ones to cancer after home-based palliative care in Japan. It evaluates the relationships between total score, each PTGI-J domain, and participants’ having a religious belief, gender, age, relationship to the patient, and time since patient death. Procedure: Bereaved family members (n = 849) completed the PTGI-J and a demographic questionnaire. The factor structure was tested using confirmatory factor analysis (CFA), and univariate analysis was used to test hypotheses. Results: Confirmatory factor analysis showed that the current sample moderately fitted to both 4-factor and 5-factor models. Univariate analysis revealed that having a religious belief and gender were associated with all domains and total PTGI-J score. Age, time since patient death, and relationship to the patient showed significant differences with the domains of PTGI-J. Conclusion: Clinicians may be able to adjust the support they provide based on patients’ personal characteristics. Future research should look at the mechanisms of PTG by examining the role of rumination, social support, and emotional distress among bereaved family members of patients with cancer.

Quality of Death, Rumination and Posttraumatic Growth among Bereaved Family Members of Cancer Patients in Home Palliative Care

The current study was designed to test the hypothesis that quality of death (QOD) and intrusive and deliberate rumination are associated with posttraumatic growth (PTG) among bereaved family members of cancer patients in home palliative care.

Posttraumatic growth in bereaved family members of patients with cancer: a qualitative analysis

BackgroundThe death of a loved one has great impact on family members even when the death was expected. While negative changes are reported, some individuals also report personal growth, known as posttraumatic growth (PTG). Many studies on PTG have been performed using quantitative methods and suggest that PTG may differ according to the traumatic event and cultural background.PurposeThis study aimed to explore how Japanese bereaved family members of patients with cancer express their experience of PTG after the patient’s death by analyzing open-ended answers provided in a cross-sectional survey.MethodsQualitative data were collected through a survey, and thematic analysis was used to analyze the data. The present study was part of a larger cross-sectional survey of bereaved families of patients with cancer. Data analyzed in the current study were obtained from 162 bereaved family members of patients with cancer.ResultsWe identified 18 sub-themes within five predefined major domains of PTG. Moreover, we also identified two additional themes: changed view of life and death, and awareness of health management.ConclusionsThe experience of PTG of bereaved family members varied considerably. Future research on PTG experiences among groups from diverse cultural backgrounds would be beneficial for understanding the concept and its clinical implications.

Hospital death in dementia patients and regional provision of palliative and end-of-life care: National patient data analysis

Abstract Hospital death is associated with poor-quality end-of-life care, and hospital is the most common death location for dementia patients. However, end-of-life care is inappropriate for dementia, which is not a terminal condition. In Japan, dementia patients receive long-term hospital treatment, with few opportunities to return home. Therefore, we examined the association between hospital death in dementia patients and regional provision of home-based end-of-life care. We analyzed 12,933 discharged dementia patients’ data from the National Patient Survey, a nationally representative cross-sectional survey examining hospital discharges. Number of patients covered by home-based end-of-life care clinics per 1,000 population in their residential regions were calculated using regional statistics. Of the 12,933 patients, 20.6% died in hospitals (average hospitalization duration: 160 days). Regional provision of home-based end-of-life care was associated with hospital death in dementia patients. However, patients in regions with high numbers of patients covered by home-based end-of-life care clinics were likelier to die in hospital than at home. Such care clinics were unsuccessful in providing end-of-life care. Furthermore, despite regional availability of home-based end-of-life care clinics, patients were likelier to die in hospital than at home. Therefore, specific strategies are needed to improve home-care clinics for dementia patients who require end-of-life care.