Caregivers In Japan Research Articles

Negotiating differences in the workplace: the Filipino and Indonesian caregiver trainees in Japan

ABSTRACT This paper reflects on the findings of a study that examined the negotiation strategies employed by Filipino and Indonesian caregivers in addressing the challenges encountered as caregivers in Japan. A total of 20 caregivers have been interviewed, 11 of which were from Indonesia, and the remaining nine were from the Philippines. Results reveal that the challenges these caregivers experienced can be rooted to cultural and linguistic and status differentials. To manage these differences, caregivers employ negotiation strategies. Negotiating differences requires the presentation of the self in a likable manner to achieve relational goals. The cultural underpinnings of caregiving led Filipino and Indonesian caregivers view their work positively, thus, device self-negotiation strategies. This paper contributes to the body of knowledge regarding social work in the context of migration, and how economic disparities between host and sending countries recast caregiving work.

Impact of Child Respiratory Syncytial Virus-Confirmed Infections on Caregivers in Japan: A Web-Based Survey.

Background/Objectives: Despite being the leading cause of acute lower respiratory tract infections in infants, the impact of respiratory syncytial virus (RSV) on the caregivers of infected children remains largely unexplored. This study is the first in Japan to examine the psychological, social, and economic burdens on caregivers of infants infected with RSV. Methods: An online questionnaire survey was used to understand the circumstances surrounding RSV infection and the psychological, social, and economic burdens on caregivers. Equal numbers of infants aged either <6 or ≥6 months were enrolled. Results: A total of 606 caregivers were included in the final analysis. Notably, 36.1% of the infants were hospitalized. Most caregivers (91.4%) felt anxious about their infants' RSV infection, and more than half (55.8%) answered that their anxiety interfered with their daily lives. Caregivers whose daily routines were disrupted due to concerns about RSV infection were more likely to hospitalize infants, particularly for extended stays. Infection significantly affected family dynamics, hindering normal daily activities and escalating stress, which in turn led to conflicts and arguments among family members (30.4%). Regarding the financial burden, most caregivers incurred medical expenses (34.2%). Additionally, 76.9% of caregivers expressed interest in the hypothetical RSV vaccination. Conclusions: In Japan, caregivers of infants with RSV experience had significant psychological burden regardless of whether the treatment is outpatient or inpatient. In addition, a non-negligible proportion of caregivers suffer from societal and economic burdens. This study lays the groundwork for all stakeholders to fully comprehend the comprehensive disease burden of child RSV infections.

Emotional labor, conflicting caregiving responsibilities and resilience among foreign female caregivers in Japan: A photovoice study

AbstractPrompted by Japan's aging population and the growing demand for migrant female caregivers, this study employs a participatory action research method—photovoice (N = 11) and interviews (N = 9) to investigate the emotional labor, conflicting caregiving responsibilities, and resilience among foreign female caregivers in Japan. A total of 47 photographs and nine interviews were gathered, revealing three main themes with several sub‐themes, such as discrimination, loneliness, ergonomic challenges, and emotional burden. The findings shed light on the stigmatization faced by foreign female caregivers in Japan, who are often perceived as inadequately qualified for their roles. It particularly emphasizes the difficulties they face in balancing their caregiving duties in Japan with the inability to care for their own families back home. Additionally, Japan's stringent immigration policies, patriarchal social structure and the experiences of discrimination further complicate their situation. We recommend that policies and programs focus on improving working conditions (such as reducing workload and increasing wages), supporting family unity, and providing greater flexibility for social integration among migrant caregivers.

Occupational low back pain among Japanese caregivers: A large-scale cross-sectional study.

Caregivers in Japan experience a high prevalence of low back pain (LBP), with age, sex, individual pain experiences, and central sensitization symptoms potentially influencing its chronic progression. To determine the prevalence of LBP among caregivers, as well as its relation to age and sex, and explore work status, psychological factors, and central sensitization symptoms as contributing factors to chronic LBP (CLBP). A large-scale cross-sectional survey was conducted among 1214 caregivers in 35 geriatric healthcare facilities. The survey assessed LBP and CLBP prevalence, work status, psychological factors, and central sensitization-related symptoms. Multivariate logistic regression analysis was used to identify factors influencing CLBP. Among 936 valid respondents, the LBP prevalence was 69.2%. No significant sex differences were found in the prevalence of LBP and CLBP. Old age, higher pain severity, and severe symptoms related to central sensitization increased the risk of CLBP. However, work status and psychological factors did not significantly contribute to CLBP. There is a high prevalence of LBP among caregivers, age and individual pain experience significantly impact CLBP. These findings emphasize the need for therapeutic strategies to manage pain intensity, especially in the acute phase, to prevent the progression to chronicity.

Preference of treatment characteristics among people with haemophilia or their caregivers, and physicians in the Japanese healthcare environment.

Studies of treatment preferences in haemophilia have been conducted in many countries. This study is the first to examine treatment characteristic preferences among people with haemophilia (PWH) and their caregivers, and physicians in Japan. To examine current treatment preferences of PWH and their caregivers, plus those of physicians at haemophilia treatment centres (HTCs) and non-HTCs for different treatment characteristics in Japan. Physicians listed on a survey panel were invited to participate in the survey and to refer PWH and caregivers to participate in the survey. Web-based surveys were conducted to examine physician and PWH/caregiver background, prophylaxis background, prophylaxis goals, understanding of haemophilia treatment products, important information sources, preferences while choosing prophylaxis products, understanding of the patient's condition, and potential product switching. A discrete choice experiment exercise was included in the survey. A total of 107 physicians and 44 PWH/caregivers participated in the study. Key treatment goals of physicians included optimisation of haemophilia management. PWH/caregivers were focused on quality of life and reduced treatment burden. Consistent differences in haemophilia treatment strategies at HTCs and non-HTCs were observed for prescribed treatments, preferences in choosing prophylaxis products, understanding of patients' condition, and reasons for potential product switch. Our study utilises real-world survey data and presents preferences for haemophilia treatment characteristics among physicians, PWH and their caregivers in Japan, which could encourage improvements in individualised treatment and disease management. Alignment between treatment approaches at HTCs and non-HTCs could facilitate improvements in the quality of care for PWH across Japan.

Profiles of psychological flexibility and caregiving experience in dementia family caregivers: A latent profile analysis.

To explore the profiles of psychological flexibility among dementia family caregivers and examine their associations with psychological well-being and caregiving factors. Participants were 521 dementia family caregivers in Japan. Latent profile analysis was conducted to explore the profiles of psychological flexibility. The analyses examined differences in depression, anxiety, life satisfaction, and work-family conflict/enrichment between the profiles, and whether sociodemographic variables and caregiving stressors predict the profile. Four distinct profiles were identified: high psychological flexibility (14.2%), moderate psychological flexibility with high commitment (24.7%), moderate psychological flexibility with low commitment (48.0%), and low psychological flexibility (13.1%). The low psychological flexibility profile exhibited the highest scores of depression, anxiety and work-family conflict, followed by the moderate psychological flexibility with low/high commitment profiles, and the high psychological flexibility profile. The high psychological flexibility and moderate psychological flexibility with high commitment profiles exhibited higher life satisfaction than the moderate psychological flexibility with low commitment profile. Caregiving stressors, marital status, and caregiver status predicted the profile. Enhancing defusion and acceptance, rather than increasing commitment to personal values, may be beneficial in supporting distressed caregivers. Having more caregiving stressors, being single/divorced/bereaved, and being a primary caregiver may be useful indicators of decreased psychological flexibility among dementia family caregivers.

Homebound elderly with dementia and their family caregivers: Examining the situation in Hong Kong, Singapore, and Japan before COVID-19

This study aimed to clarify the status of problematic behaviors among elderly patients with dementia at home and the associated burden on their family caregivers in Japan, Hong Kong, and Singapore immediately before the COVID-19 pandemic. The study included 563 family caregivers of elderly patients with dementia living at home in these three regions. Information regarding their demographic characteristics, such as age, gender, education level, income, marital status, and family status, was obtained. The Revised Memory and Behavior Problems Checklist, a 24-item scale for assessing problem behaviors, and the Zarit Burden Interview, a 22-item scale for measuring caregiver burden, were used alongside other relevant scales. The findings indicated that the majority of family caregivers were female and in their 60s across all three regions, while elderly patients with dementia were mostly female and living alone in their 80s. In addition, a significant proportion of these patients had comorbidities such as diabetes and other health conditions. In Japan, although the patients exhibited relatively intact physical function and a low degree of dementia, the caregivers experienced high-stress levels. The demographic profiles of family caregivers of elderly patients with dementia at home in Hong Kong, Singapore, and Japan were remarkably similar, particularly in terms of age and gender distribution. Furthermore, marital and employment statuses were comparable between Hong Kong and Singapore. While the previous studies have taken a broad view of Asia, focusing on Hong Kong, Singapore, and Japan in particular has facilitated the identification of clues for developing targeted countermeasures.

Inaccessibility, unresponsiveness, inconsistency, and invisibility of informal caregivers of older persons with cognitive impairment: community-based participatory research

BackgroundStudies on informal caregivers in Japan have been limited to family caregivers and largely conducted where family caregivers generally gather. Family caregivers who do not visit such places or non-family caregivers are generally overlooked, and data on these informal caregivers remains scant. Consequently, a framework is needed through which healthcare professionals can approach the informal caregivers of community-dwelling older persons. Therefore, this study approaches such informal caregivers and proposes a classification system for them from the starting point of older persons living in the community with cognitive impairment.MethodsIn 2016, we conducted an epidemiological survey of 7000 + community-dwelling older persons and identified 198 residents with Mini-mental state examination scores less than 23. A team of healthcare professionals contacted them regularly. By 2022, 92 people were still living in the community, and we systematically asked them about their informal caregivers. After approaching the caregivers and obtaining informed consent, we mailed separate questionnaires to older persons and informal caregivers.ResultsAmong the caregivers, 59%, 34%, and 3% were the child, spouse, and sibling of the older person, while the remaining 4% were non-family caregivers. Except for two daughters-in-laws, all children were biological children of the older person. Male caregivers (46%) tended to have full-time jobs, whereas female caregivers (54%) tended to face financial difficulties. Only 3% of the caregivers had joined a family caregivers’ association. Caregivers’ reason for not joining such organizations was a lack of time and knowledge. A 3-tiered classification system was developed for these informal caregivers: (1) the household form, (2) accessibility, and (3) the reciprocal awareness of caregiving. Furthermore, family caregivers who lived with the older person or visited them more than once a week with reciprocal awareness of caring and being cared, or “traditional caregivers,” accounted for 68% of the caregivers in this study.ConclusionCore family caregivers can be easily approached at places where such caregivers generally gather. However, there also exists a group of informal caregivers who are sometimes inaccessible, unresponsive, and invisible to healthcare professionals. Moreover, their awareness of caregiving is sometimes inconsistent.

Community-Based Hip Screening for Up to Four-Month-Old Infants and Health Guidance for Their Caregivers in Japan: A Nation-Wide Survey.

Early detection of developmental dysplasia of the hip (DDH) in children is crucial. Due to COVID-19, maternal and child health services have been suspended temporarily, increasing the risk of late detection of DDH. This study aimed to reveal Japan's current situation regarding community hip screening for newborns and infants and to provide health guidance for caregivers regarding DDH. A web-based, nationwide cross-sectional survey was conducted between February and March 2023 (n = 1737). One public health nurse overseeing maternal and child health per municipality responded to the 2022 municipality hip screening system. Among the 436 municipalities that responded (response rate: 25.1%), 97.5% implemented hip screening within 4 months, and approximately 60% performed it during newborn home visits, while only 2.3% conducted hip ultrasound screening. Perfect checking of the risk factors for DDH during newborn home visits and training opportunities for home visitors must be improved. Educational programs regarding DDH for home visitors and caregivers are needed to prevent the late diagnosis of DDH. Furthermore, collaboration between pediatric orthopedic surgeons and nurses is crucial for developing effective community-based hip-screening systems by bridging the evidence and practice gap in the early detection of DDH.

Factors Contributing to Life-Change Adaptation in Family Caregivers of Community-Dwelling Individuals with Acquired Brain Injury.

Acquired brain injury (ABI) is a public health issue that affects family caregivers, because individuals with ABI often require semi-permanent care and community support in daily living. Identifying the characteristics of family caregivers and individuals with ABI and examining life-change adaptation may provide valuable insights. The current study sought to explore the factors contributing to life-change adaptation in family caregivers of community-dwelling individuals with ABI. As a secondary analysis, a cross-sectional study was conducted using data obtained in a previous study of 1622 family caregivers in Japan. We hypothesized that life-change adaptation in family caregivers of individuals with ABI would also be related to family caregivers' characteristics and the characteristics of individuals with ABI. In total, 312 valid responses were analyzed using Poisson regression analysis. The results revealed that life-change adaptation in family caregivers of individuals with ABI was related to sex (prevalence ratio [PR]: 0.65, confidence interval [CI]: -0.819;-0.041) and mental health (PR: 2.04, CI: 0.354; 1.070) as family caregivers' characteristics, and topographical disorientation (PR: 1.51, CI: 0.017; 0.805) and loss of control over behavior (PR: 1.61, CI: 0.116; 0.830) as the characteristics of individuals with ABI, after adjusting for the effects of the caregiver's age, sex, and the duration of the caregiver's role. The current study expands existing knowledge and provides a deeper understanding to enhance the development of specific policies for improving caregiving services and supporting families.

The Current Situation and Challenges for Caregivers in Japan

The total population of Japan is 125.5 million (as of October 1, 2021). Of this population, 36.21 million are aged 65 and over, accounting for 28.9% of the total population (aging rate). This is unprecedented in the world. The age of the main caregivers living with a person requiring nursing care in Japan is 72.4% for men and 73.8% for women aged 60 or older. This indicates that there are a considerable number of cases of so-called "aged care. Therefore, in this study, the authors focus on caregivers and examine cases from the viewpoint of family support for the current state of caregiving that has emerged.

Associations between caregiver burden and care receivers' sharing ratio of household tasks among spousal caregivers.

We assessed care receivers' sharing ratios of household tasks before they required care and investigated their relationship with caregiver burden. A cross-sectional, online survey was completed by 272 spousal caregivers in Japan. Caregiver burden was assessed using the Zarit Burden Interview. Low and moderate-to-high caregiver burdens were defined as those with scores ≤40 and ≥41, respectively. Additionally, caregiver responses to, "How much did your partner contribute to household tasks before the onset of their condition that needed care?" were scored on a 10-point Likert scale ranging from 1 to 10. We defined answers that scored 1-4 as a low sharing ratio and those that scored 5-10 as a high sharing ratio of household tasks of care receivers before developing a condition that required care. Among the husband and wife caregivers, moderate-to-high caregiver burden in 33 (25.0%) and 48 (34.3%) caregivers, respectively. Multivariate logistic regression analysis showed that among the husband caregivers, the high sharing ratio of household tasks of their wives before developing a condition that required care was significantly associated with their caregiver burden (OR 4.55, 95% CI 1.20-17.27); however, no such association was observed among the wife caregivers (OR 0.85, 95% CI 0.37-2.29). Among husband, but not wife caregivers, the high sharing ratio of household tasks of their wives before they required care was significantly associated with their caregiver burden. Geriatr Gerontol Int 2023; 23: 616-621.

Survey on the Impact of the COVID-19 Pandemic on Patients with Parkinson's Disease and Their Caregivers in Japan.

The coronavirus disease 2019 (COVID-19) pandemic changed the lives of patients with Parkinson's disease (PD) and their caregivers. This study aimed to investigate changes in patient behavior and PD symptoms and their effect on caregiver burden resulting from the COVID-19 pandemic in Japan. This nationwide, observational, cross-sectional survey included patients with self-reported PD and caregivers (members of the Japan Parkinson's Disease Association). The primary objective was to evaluate changes in behaviors, self-assessed PD symptoms, and caregiver burden from pre-COVID-19 (February 2020) to post-national state of emergency (August 2020 and February 2021). Responses from 1883 patients and 1382 caregivers from 7610 distributed surveys were analyzed. Mean (standard deviation) age of patients and caregivers was 71.6 (8.2) and 68.5 (11.4) years, respectively; 41.6% of patients had a Hoehn and Yahr (HY) scale of 3. Patients (>40.0%) reported decreased frequency of going out. Most patients (>70.0%) reported no change in treatment visit frequency, voluntary training, or rehabilitation and nursing care insurance services. Symptoms worsened for approximately 7-30% of patients; the proportion with HY scale 4-5 increased from pre-COVID-19 (25.2%) to February 2021 (40.1%). Aggravated symptoms included bradykinesia, walking, gait speed, depressed mood, fatigue, and apathy. Caregivers' burden increased because of patients' worsened symptoms and reduced time going out. Control measures during infectious disease epidemics should consider that patients' symptoms may worsen; therefore, patient and caregiver support is needed to reduce burden of care.

Elderly long-term care policy and sandwich caregivers’ time allocation between child-rearing and market labor

Using an overlapping generations model, we present analyses of public long-term care provision effects on fertility and time allocation decisions of sandwich caregivers, those caring for young children and old parents simultaneously. If the public long-term care level runs short of the necessary level, then working children must compensate for the difference by spending their time. Reportedly, about a third of university students’ parents are sandwich caregivers in Japan, although Japan has a Long-Term Care Insurance system, which is a mandatory system with universal coverage. With a rapidly aging population, demand for long-term care is predicted to increase, thereby affecting family time allocation, e.g., fertility decisions, in Japan. Results show that if public long-term care production is costly relative to family care provision, then increases in public care provision lower the fertility rate. If labor productivity in the public long-term care sector improves, then it increases the fertility rate by freeing caregivers’ time from family care provision. It will also increase social welfare. The effects on labor employment in the goods production sector are generally ambiguous because the increased public care provision requires more labor.

Analysis of Conditions and Problems of Pre-Departure Training for Caregiver Candidate Internships in Indonesia

Within a decade, starting in 2008, the Japanese government opened up the acceptance of foreign workers in the caregiver field, and Indonesia is one of the countries with the most significant number of senders of caregivers in Japan. There are at least four routes for sending caregivers to Japan, one of which is through sending caregiver interns "Kaigo Ginou Jisshuu." This study analyzes the conditions and problems of pre-departure training for caregiver intern candidates in Indonesia. The method used in this study is qualitative and quantitative. Data collection techniques used were interviews, observations, and questionnaires. This study used a purposive sampling technique. The "Ginou Jisshuu" program, through the case study of Nagomi Kaigo Gakkou, can be described that most teachers at LPK are interns with quite high Japanese language skills and experience living in Japan, where this becomes potential in teaching Japanese to prospective interns. The results of this research can become a reference for higher education institutions in community service activities, especially in improving Japanese language teaching in LPK.

Incarcerated Mothers’ Parenting Prospects and the Associated Relational Issues With Their Children and Children’s Caregivers in Japan

Reunification with children is expected to be an exciting prospect for incarcerated mothers, but reunification process is an immense challenge due to a wide range of relational issues with their children and children’s caregivers. This study aimed at identifying relational issues that may impede incarcerated mothers’ parenting prospects by analyzing data of the incarcerated mothers in Japan. The results found that majority of mothers (73.3%) had positive parenting prospects, while 26.7% of them had negative parenting prospects. Mothers with negative parenting prospects had less contacts during incarceration, less likely to perceive their relationships with the caregivers positively, their child was more likely to know of maternal incarceration and had fewer parenting-support resources available, especially from the family. Prison-based interventions that effectively address those relational issues are discussed, which considered to reduce potential barriers for future reunification.

PCR61 The Burden of Spinal Muscular Atrophy Type 2 (SMA2) on Caregivers in Japan, United Kingdom, and United States: Results of a Global Survey

SMA2, a rare, genetic neuromuscular disease that causes loss of both voluntary motor and bulbar functions, accounts for 40–50% of all SMA cases worldwide. Because data on caregiver burden associated with SMA2 are sparse, we sought to describe out-of-pocket expenditures and time costs for the families/caregivers of these patients, as well as health care resource utilization (HCRU). Here, we present initial data reflecting caregiver burden in Japan, UK, and US.

PCR59 Assessing the Utility Associated with Caregiving in Alzheimer's Disease (AD) with Mild Cognitive Impairment (MCI) and AD Dementia in Japan

Dementia is a debilitating, progressive condition that often places caregiving responsibility on unpaid caregivers, causing a substantial burden to caregivers. Caregiver utility comprises an important part of this burden and should be considered when assessing interventions for AD dementia. This study aimed to quantify the utility of AD with MCI and AD dementia caregivers in Japan.

Association between caregivers' health-related quality of life and care recipients' health outcomes.

This study aimed to investigate the relationship between family caregivers' health-related quality of life and health outcomes in care recipients. A total of 160 female caregivers in Japan were initially assessed using self-reported baseline questionnaires to determine physical and mental aspects of their health-related quality of life. Based on these scores, they were divided into three groups: lower, middle, and higher quality of life. We followed up with the 133 participants (after excluding those that did not respond) 6years later to assess the health of their care recipients; 36 caregivers continued to provide home care, while 97 reported that their care recipient had died or been admitted into institutionalized care. Statistically, a higher risk for care recipients' health deterioration was strongly associated with the mental component score in the lower caregivers' quality of life group of than for the middle group, after adjusting for the care recipients' age, health status, and caregivers' age at baseline. There was no significant association between deterioration of health of care recipients and physical component scores of the caregivers. Caregivers' poor health-related quality of life, particularly poor mental health, may be linked to the deterioration of care recipients' health.

POSC158 The Burden of Spinal Muscular Atrophy Type 1 (SMA1) on Caregivers in Japan: First Results of a Global Survey

SMA1, a rare, genetic neuromuscular disease that causes loss of both voluntary motor and bulbar functions, is usually fatal by 2 years of age if untreated. As data on caregiver burden associated with SMA1 are sparse, we sought to describe out-of-pocket expenditures and time costs for the families/caregivers of these patients, as well as healthcare resource use (HCRU). Here, we present initial data reflecting caregiver burden in Japan.