This study aims to clarify the dynamics of information provision and human interaction to satisfy the needs of family caregivers. A questionnaire survey consisting of items on information received at and after diagnosis, persons and resources consulted, needs, and caregiver-oriented outcomes was conducted. Among the respondents, 2295 individuals who were caring for people with dementia were divided into quartiles by the time after diagnosis, and differences were statistically analyzed. The time after diagnosis in the first to fourth quartiles was 0.73 ± 0.4, 2.52 ± 0.49, 4.89 ± 0.73, and 10.82 ± 3.7 years, respectively. The number of persons consulted by family caregivers increased significantly from the first to the fourth quartiles (p < 0.001). During this time, attributes of professionals and informal supporters changed depending on the quartile. As time progressed, acceptance of the diagnosis increased, but so did its impact on the lives of family caregivers. These findings revealed differences over time in what family caregivers wanted and the dynamics of interactions that filled their needs. Informal supporters accounted for a significant proportion of the total resources. However, many family caregivers thought the information and support were insufficient. Thus, continuous reform of the care pathway is needed.

Aims:We conducted an intervention study to clarify how effectively telemedicine system using multi-functional videophone could be used in lifestyle guidance, with a special focus on diet for diabetic patients cared for at home.Methods: Patients were assigned to a 3-month intervention group or to a usual care group. In the intervention group, patients and a medical professional communicated bi-directionally through a videophone-based communication system for 30 minutes, once a week. The participants were encouraged to send pictures of each meal online, through the videophone system, in real time.Results: Intra-subjective comparison, the 3-month intervention program resulted in a significant decrease in the Body Weight (BW) (p<0.0005), and the average HbA1C level (p<0.005) compared to before intervention program. Three months after the conclusion of the intervention program, the average HbA1C level returned to almost the same levels as it was at the pre-intervention stage (p<0.05). In usual care group, the average HbA1C level did not change significantly for six months.Conclusions: 3-month intensive communication using the multimodal videophone system led to a significant decrease in BW and average HbA1C level. This novel bi-directional communication is useful for improving conditions of diabetes, BW, and hyperglycemia of homecare diabetes patients, thus, -reducing cardiovascular risk.Keywords: Videophone; Multimodal; Telecare; Homecare. recent decades. In 2007, approximately 8.9 million people were estimated to have diabetes. Also, there were approximately 13.2 million people with possibilities of developing diabetes [2]. The pathogenesis of type 2 diabetes is characterized by increased peripheral insulin resistance and decreased insulin secretion, which lead to complications such as diabetic neuropathy, nephropathy, and retinopathy. Thus, it is important for patients with diabetes to prevent complications of diabetes by improving glycemic control through sequential therapy. To date, a sedentary lifestyle and Westernized high-calorie diet, which result in overweight, have been considered to be associated with an increased risk for the development of diabetes [3][4][5]. Therefore, the introduction of weight management, energy-restricted diet, and a physically active lifestyle, is thought to be the primary approach in the treatment of diabetes. A lot of studies demonstrated that lifestyle interventions, including energy-restricted diet, exercise habit, and cognitive behavior therapy, would yield significant behavioral improvements, as well as weight loss and better glycemic control [6-10].In Japan, lifestyle education for diabetes is mainly conducted in hospitals. Patients with diabetes are hospitalized for education for a short time and given self-management training, which includes dietary intervention, exercise therapy, and drug therapy, under the direction of professionals such as doctors, nurses, and nutritionists in hospitals. After the in-hospital training program, the patients with diabetes are expected to o...

No abstract

Background:As policies aimed at deepening the understanding of dementia have become a global issue, to reduce the stigma of the condition and to realize a society of symbiosis, we will clarify the conceptions that the general public have about people with dementia. We will also examine the effects that existing initiatives and social resources have on public understanding of people with dementia.Methods: In this study, we prepared 18-item questionnaire polling respondents' conceptions of people with dementia and conducted an attitude survey using this questionnaire among 12,410 citizens. Using our obtained data, we extracted the latent factors that make up the conceptions of people with dementia through exploratory factor analysis. Further, we ascertained whether respondents had attended dementia supporter training courses, the extent of their knowledge of social resources related to dementia, and their level of experience with people with dementia. We tracked differences in factor scoring to examine how these factors contributed to positive conceptions of people with dementia.Results: As a result of our factor analysis, we extracted the following factors as making up conceptions of people with dementia -Factor I: Person-centredness, Factor II: Behavioral and psychological symptoms of dementia, Factor III: Forgetfulness, and Factor IV: Unknown anxiety. Further, we found that the group that had attended dementia supporter training courses, the group that was highly aware of social resources such as long-term care insurance, dementia cafés, and supporter groups, and individuals who had frequent opportunities to interact with people with dementia all had significantly higher factor scores for Factor I, Person-centredness.Discussion: In Japan, positive and negative conceptions of people with dementia often exist alongside one another. To reduce stigma and encourage person-centredness, it is important to provide opportunities to learn about dementia, to spread awareness of social resources, and to interact with people with dementia.