The purpose of this study was to examine factors of positive appraisal of care among Japanese family caregivers of older adults. The Positive Appraisal of Care (PAC) scale used in this study is a multidimensional Japanese measure and has four domains: relationship satisfaction, consequential gain, role confidence, and normative fulfillment. Three hundred and thirty-seven caregivers participated in this survey. Multiple regression analyses revealed that social support and caregiver belief in caregiving had a consistent impact on all domains of the PAC, whereas the impact of caregiver and care recipient characteristics varied among the domains. For example, caregiver age had a significant impact on role confidence and normative fulfillment but not on relationship satisfaction and consequential gain. The differential impact of caregiver and care recipient characteristics on the domains of the PAC underlines the usefulness of a multidimensional measurement.

Most family caregiving research has portrayed caregiving as a negative life experience for caregivers, but a broader perspective is necessary to examine its impact on the caregiver quality of life (QL). The role that positive appraisal of care plays in the caregiving experience among Japanese families of older adults was examined in relation to the caregiver's subjective QL. Positive as well as negative appraisal of care was measured by a newly developed multi-dimensional scale, which included the domains of 'relationship satisfaction,' 'role confidence,' 'consequential gain,' 'normative fulfillment' (positive appraisal), 'role exhaustion,' 'isolation,' 'relationship difficulty,' and 'symptom management difficulty' (negative appraisal). Subjective QL was measured by WHO/QL-26. Altogether 337 Japanese family caregivers participated in this survey. Stepwise multiple regression analyses revealed that 'role confidence,' 'normative fulfillment,' and 'role exhaustion' had a significant independent impact on physical QL, while 'role confidence' and 'role exhaustion' on psychological QL. The association of 'normative fulfillment' with physical QL was negative while that of 'role confidence' was positive, despite the positive correlation between the two domains. The results underline the importance of considering positive as well as negative appraisal of care when examining subjective QL of the family caregivers.

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Subjects were divided regarding to island group based on the availability of nursing facility care.To estimate the behavioral dimensions of subjects based on data similarities and mutual relationships, correlation axes for preferences about living on or off the island and with families or independently were extracted using Hayashi's third method of quantification.In the facility available island group, living with family off the island was most common among elderly people, while most young and middle aged people wanted to remain on the island, representing significant intergenerational differences. In contrast, in the facility unavailable island group, living on the island was common in all generations.These results indicate that living preferences during the care period for elderly people living on small isolated islands are influenced by the current state of nursing care for the elderly both on and off isolated islands.Key words living preferences during the care period, small isolated island, availability of nursing care facilities, intergenerational differences during the care period, Okinawa