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Background: Dementia with Lewy bodies (DLB) is characterized by neuropsychiatric symptoms, which can be distressing to caregivers. However, little is known about their subjective distress in terms of caregiver self-efficacy. Thus, we examined the differences in caregiver self-efficacy and their associated factors between DLB and Alzheimer's disease (AD) caregivers. Methods: We conducted a comprehensive questionnaire for DLB and AD caregivers. Caregiver self-efficacy was evaluated using three domains (Self-Efficacy for Obtaining Respite: SE-OR, Self-Efficacy for Responding to Disruptive Patient Behaviours: SE-RDPB, Self-Efficacy for Controlling Upsetting Thoughts about Caregiving: SE-CUT) of the Revised Scale for Caregiving Self-Efficacy (RSCSE). In addition, data on the following features of caregivers were assessed: depression, sleep disturbance, caregiver burden, executive function, loneliness, social support, and distress associated with neuropsychiatric symptoms. The patients were assessed for general cognitive tasks, executive function, and neuropsychiatric symptoms. Results: Compared with AD caregivers, DLB caregivers experienced a significantly higher burden in terms of not only various clinical factors, but also all three domains of caregiver self-efficacy. Among the caregiverassociated factors, different domains were predictors of self-efficacy in DLB and AD caregivers (distress due to sleep disturbances in DLB patients; distress due to delusions in AD patients). Among the patient-associated factors, different domains were also predictors of self-efficacy in DLB and AD caregivers (sleep disturbances in DLB patients; delusions in AD patients). Among both the caregivers and the patients, executive function was a significant predictor of one RSCSE domain (SE-CUT). Conclusions: A reduction in caregiver self-efficacy may contribute to a severe subjective burden among DLB caregivers. Furthermore, two neuropsychiatric symptoms (delusions and sleep disturbances) affected caregiver self-efficacy differently depending on whether care was being provided to a DLB or AD patient. Understanding the association between specific neuropsychiatric symptoms and caregiver self-efficacy may be useful for conducting interventions for DLB patients.

Background The Quality of Life in Alzheimer's Disease Scale (QOL‐AD) developed by Logsdon et al. in1999 is believed to be useful for evaluating responses from both patients and their caregivers. We previously confirmed both the reliability and the validity of the Japanese version of the QOL‐AD. However, the factor structure of this scale should be confirmed because the QOL‐AD covers multiple facets of dementia patients’ lives. Thus, we performed a factor analysis of the Japanese QOL‐AD. Then, we examined the correlations between each of the identified QOL factor scores and the results of other scales. Methods The Japanese version of the QOL‐AD was given to 132 AD patients and 132 caregivers. Four other tests were also performed at the same time: the Mini‐Mental State Examination, the Neuropsychiatric Inventory (NPI), the Hyogo Activities of Daily Living Scale (HADL), and the Short Memory Questionnaire. A factor analysis using Varimax rotation was used to examine the dimensions underlying the QOL‐AD. In addition, we examined the Pearson correlations between each of the identified QOL factor scores and the results of the other four tests. Results Factor analyses of both versions of the Japanese QOL‐AD (both the patients’ and the caregivers’ responses) revealed three factors that were named ‘psychological wellbeing’, ‘human relationships’, and ‘physical and social environment’. The ‘psychological wellbeing’ factor was significantly correlated with the Mood factor of the NPI. The ‘human relationships’ factor was significantly correlated with the Psychosis factor of the NPI. The ‘physical and social environment’ factor was significantly correlated with the HADL. Conclusions Both the patients’ and the caregivers’ responses to the Japanese version of the QOL‐AD were composed of three factors: ‘psychological wellbeing’, ‘human relationships’, and ‘physical and social environment’. The present results support the multi‐domain concept of QOL proposed by Lawton.

Parenting support and abuse prevention are pressing agendas in Japan. In the 1980s, open dialogue (OD) has emerged as a treatment option for mental illnesses in Finland. We held six training sessions using the OD approach at a child guidance center from 2017 to 2019. Each session consisted of a lecture and role-plays, and participants' reflections were gathered through a feedback sheet after each session. Moreover, we interviewed one staff member after the training. Our OD training with the child protection staff is reported, and the possibilities and challenges are discussed. The participants were 104 staff members of the child guidance center, and in total, 73 feedback sheets informed us regarding the achievements and concerns of our training session. The categories of awareness, new experiences, and trust to therapists emerged as achievements, whereas categories of questions, difficulties, uncertainty, and the need for further learning emerged as concerns. From a 102-min interview with one child guidance staff, we acquired his interest in dialogue, impressions, and feedback on our training. He informed us of the difficulties in dialogue between the families and facilities with authority, necessity of early contact, possibilities of OD in child protection, and suggestions for OD training. Our training was part of an exposure program. However, the participants deepened their understanding of the dialogic approach. As per our findings, we realized that OD and its training were suitable for the field of parenting support. The conditions of organizational training, such as costs, timing, location, and resource availability, should thus be improved.