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Our research aims to clarify the thinking processes involved in care work of care workers who care for the elderly. We conducted interviews with 12 care workers working in an elderly day‐care center and analyzed the data with the Modified Grounded Theory Approach (M‐GTA). As a result, 26 concepts were generated. Next, these concepts were divided into eight categories and further summarized into four central categories. The structure of the care worker's thinking was explained according to four central categories: Think about care attitude, Determine care attitude, Care for the users, and Foundation of care. From these results, we confirmed that care workers attach great importance to maintaining their three central categories of thinking processes and foundation of care to provide quality care to the users. We also confirmed that the three central categories are divided into positive and negative concepts that affect the quality of care for the users. Accordingly, to provide high‐quality care for elderly users, it is necessary to consider the organizational mechanisms that support care workers' three thinking processes and foundation of care. [ABSTRACT FROM AUTHOR]

Background: Dyspnea is a common distressing symptom in patients with malignant and nonmalignant diseases. Fan therapy, which uses a fan to blow air toward the patient's face, can alleviate dyspnea; however, its efficacy remains unclear. Aim: To examine the immediate efficacy of fan therapy for alleviation of dyspnea at rest. Design: Meta-analysis. Data sources: We searched the Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE EBSCO, CINAHL EBSCO, and Scopus from January 1, 1987, to August 21, 2018 (PROSPERO-CRD42018108610). In addition, we hand-searched studies and used the similar articles feature on PubMed to search for articles. Randomized controlled trials comparing the effects of fan therapy with placebo or other interventions to alleviate dyspnea at rest, in which patients were aged ≥18 years, were eligible for inclusion in the review. We excluded articles on long-term intervention involving fan therapy and complex intervention (including fan therapy). The risk of bias assessment was conducted using the Cochrane tool, and the meta-analysis was performed using RevMan version 5.3. Results: We identified a total of 218 studies; 2 met our criteria for inclusion in the meta-analysis. Fan therapy significantly improved dyspnea at rest in terminally ill patients with cancer compared to control groups (mean difference: −1.31, 95% confidence interval: −1.79 to −0.83, P <.001). There were no studies that met the inclusion criteria regarding fan therapy for patients with nonmalignant disease. Conclusions: This meta-analysis demonstrated that fan therapy may be an effective intervention for dyspnea at rest in patients with terminal cancer. [ABSTRACT FROM AUTHOR]

Objectives: Even if patients with terminal cancer hope to spend the rest of their lives at home, they are often unable to leave the hospital early due to their family caregivers’ anxiety. This study aimed to investigate in Japan the discrepancies between the supports needed by and actually provided by palliative care unit nurses (PCUNs) to the family caregivers for discharge of patients with terminal cancer. Methods: In this cross-sectional study, self-administered questionnaires including 6-point Likert-type scales assessing the reasons for difficulties in transition to home-based care were distributed to 1227 PCUNs. Using paired t tests, the differences between the scores on perceived importance and actual supports to family caregivers were examined. The supports actually provided were classified by factor analysis. The relationships between the PCUNs’ characteristics and mean scores on the supports in each category were examined using multiple regression analysis. Results: A total of 1023 (83.4%) completed questionnaires were returned. Scores on the actually provided supports for discharge to family caregivers were consistently and significantly lower than the corresponding scores on perceived importance for all 57 items (P < .001). Factor analysis revealed that the supports actually provided to the family caregivers had a 4-factor structure. Multiple regression analyses revealed that gaining experience in palliative care, receiving necessary training, cooperating with palliative care staff, and cooperating with local service providers were significantly associated with higher levels of actual supply of supports to family caregivers. Conclusion: Our findings suggest that PCUNs need to be encouraged to provide further support to family caregivers for the discharge of patients with terminal cancer. [ABSTRACT FROM AUTHOR]

Our research aims to clarify the thinking processes involved in care work of care workers who care for the elderly. We conducted interviews with 12 care workers working in an elderly day‐care center and analyzed the data with the Modified Grounded Theory Approach (M‐GTA). As a result, 26 concepts were generated. Next, these concepts were divided into eight categories and further summarized into four central categories. The structure of the care worker's thinking was explained according to four central categories: Think about care attitude, Determine care attitude, Care for the users, and Foundation of care. From these results, we confirmed that care workers attach great importance to maintaining their three central categories of thinking processes and foundation of care to provide quality care to the users. We also confirmed that the three central categories are divided into positive and negative concepts that affect the quality of care for the users. Accordingly, to provide high‐quality care for elderly users, it is necessary to consider the organizational mechanisms that support care workers' three thinking processes and foundation of care. [ABSTRACT FROM AUTHOR]

We read with interest the recent paper entitled "Factors associated with long-term impact on informal caregivers during Alzheimer's disease dementia progression: 36-month results from GERAS" by Reed I et al i . We believe that longitudinal studies emphasizing caregiver burden, functional abilities and behavioral symptoms will be beneficial in understanding the burdens of caregivers of persons with dementia. [Extracted from the article]

We read with interest, the recent article titled, "Informal caregiver quality of life in a palliative oncology population" by Duimering et al. [[1]], in which the authors concluded that identification of factors relating to lower quality of life (QOL) for informal caregivers, including additional employment, cohabitation with the patient, poor patient performance status, and expressing the wish to provide more assistance, should actuate the healthcare team to identify the vulnerable informal caregivers. Duimering et al. found that additional employment, cohabitation, poor patient performance status, and expression of interest in more assistance significantly related to a lower QOL [[1]]. However, previous research reported that the caregivers' age and relationship with the patient were related to the QOL of caregivers of patients with cancer [[2]]. [Extracted from the article]

It is noteworthy that Connors et al found around half of caregivers to display clinically significant levels of caregiver burden, with the proportion impacted increasing steadily over the 3-year period.[1] Previous longitudinal studies among caregivers of persons with dementia also found mean caregiver burden scores to increase from baseline over 36 months.[[2]] Moreover, Reed et al[2] showed that caregiver burden tended to increase every 6 months. Few previous studies have assessed caregiver burden and individual neuropsychiatric symptoms using longitudinal data among caregivers of patients with dementia. We believe that consideration of caregiver burden and caregiver gender will help improve the in-home support of caregivers. [Extracted from the article]

Impacts of a multicomponent intervention programme on neuropsychiatric symptoms in people with dementia and psychological health of caregivers: a feasibility pilot study. Patient and caregiver benefit from a comprehensive dementia care program: 1-year results from the UCLA Alzheimer's and Dementia Care Program. [Extracted from the article]

We read with great interest the recent article by Trevino et al.[1] The authors concluded that the rates of hospice enrollment differed according to patient-caregiver agreement regarding the patient's prognosis and perception of future quality of life. First, we agree with the authors that if the patient and caregiver have an optimistic view of the patient's prognosis and future quality of life, providing prognostic information may decrease unrealistic optimism. Undoubtedly, it is important to focus on the association between patient-caregiver agreement regarding the patient's prognosis and future quality of life with the rate of hospice enrollment. [Extracted from the article]

Sennfält and Ullberg showed that 89.6% of informal caregivers to completely dependent patients were unable to follow their own interests; caregivers to partially dependent patients had reduced working hours. A recent study[5] described a positive emotional support-utilizing technology that may be effective in busy caregivers to stroke patients. 1 Sennfält S and Ullberg T. Informal caregivers in stroke: life impact, support, and psychological well-being - a SwedishStroke Register (Riksstroke) study. [Extracted from the article]

Context: The Dyspnea-12 questionnaire is a simple tool to assess dyspnea using qualitative descriptors that include both physical and emotional domains. However, the reliability and validity of the Japanese version in patients with lung cancer have not been assessed.Objective: To determine the reliability and validity of the Japanese version of the Dyspnea-12 questionnaire in patients with lung cancer.Methods: The assessment was based on the numerical rating scale (NRS), cancer dyspnea scale (CDS), and hospital anxiety and depression scale (HADS). Spearman's correlation assessed the convergent validity of Dyspnea-12 using these three scales. Exploratory factor analysis examined the construct validity. The reliability was verified using Cronbach's alpha. Anxiety, depression, clinical dyspnea, presence of chronic obstructive pulmonary disease (COPD), and patient status were identified by discriminating performance.Results: The analysis included 113 patients with lung cancer. A significant positive correlation was found between Dyspnea-12 and NRS, CDS, and HADS scores. Similar to the original version, factor analysis clearly classified Dyspnea-12 into two components (physical and emotional), thereby confirming its construct validity. Cronbach's alpha values for the total Dyspnea-12 and its physical and emotional components were 0.97, 0.95, and 0.96, respectively. Patients with anxiety, depression, and clinical dyspnea and those in the palliative phase had significantly higher Dyspnea-12 scores than their respective counterparts. The Dyspnea-12 scores of patients with and without COPD were similar.Conclusion: The Japanese version of the Dyspnea-12 questionnaire is a useful and reliable tool to assess the multi-dimensional aspects of dyspnea in patients with lung cancer. [ABSTRACT FROM AUTHOR]