The implementation of the BASE programme resulted in a reduction of challenging behaviour of home-dwelling people with dementia. Future research should examine the long-term effects of behaviour management programmes on behaviour, nursing home placement, and hospital admission of home-dwelling people with dementia.

Parentally bereaved adolescents reported higher grief reactions. [corrected]. Nurses should ensure bereaved adolescents receive appropriate support.

Background: Although confidence in providing palliative care services is an essential component of providing such care, factors relating to this have not been investigated in Japan. Objective: This study aimed to explore confidence in the ability to provide palliative care and associated difficulties and to explore correlations between these variables. Design: A cross-sectional mail survey of medical doctors and registered nurses in Japan was performed as part of a regional intervention trial: the Outreach Palliative Care Trial of Integrated Regional Model study. Subjects: Questionnaires were sent to 7905 medical professionals, and 409 hospital doctors, 235 general practitioners, 2160 hospital nurses and 115 home visiting nurses completed them. Results: Confidence in providing palliative care was low and difficulties frequent for all types of medical professionals assessed. In particular, only 8 -24% of them, depending on category, agreed to 'having adequate knowledge and skills regarding cancer pain management'. In particular, 55 -80% of medical professionals acknowledged difficulty with 'alleviation of cancer pain'. Multiple regression analysis revealed that confidence was positively correlated with the amount of relevant experience and, for medical doctors, with 'prescriptions of opioids (per year)'. Moreover, difficulties were negatively correlated with the amount of relevant clinical experience. Conclusions: Effective strategies for developing regional palliative care programs include basic education of medical professionals on management of cancer-related pain (especially regarding opioids) and other symptoms.

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 programme's effectiveness on the challenging behaviour of persons with dementia.

The ongoing multi-agency discussion meetings, with a focus on challenging behavior, may have been the key component in the psychosocial dementia care program. Pain management should be emphasized in action plans for challenging behavior.