ORIGINAL ARTICLE: SOCIAL RESEARCH,
PLANNING AND PRACTICE
Effectiveness of educational program using printed
educational material on care burden distress among staff of
residential aged care facilities without medical specialists
and/or registered nurses: Cluster quasi-randomization study
and Kenji Toba
Department of Psychiatry,
Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and
Gerontology, Obu City,
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutics
Faculty of Life Sciences, Department of Neuropsychiatry, Kumamoto University, Kumamoto,
Psychogeriatrics, Kamiiida Daiichi General Hospital, Nagoya,
Department of Psychiatry, Juntendo Tokyo Koto Geriatric Medical Center,
Faculty of Nursing, Hamamatsu University School of Medicine, Shizuoka,
Geriatric Health Service Faculty, Luminous Obu City,
Long-term Care Health Facility, Wakaba no Sato, Nagoya and
Division of Biostatistics, Clinical Research Center, Aichi Medical
University Hospital, Nagakute, Japan
Aim: Behavioral and psychological symptoms of dementia are an important source of distress for caregivers. The
aim of the present study was to evaluate the effectiveness of educational intervention using printed educational mate-
rial for reducing distress induced by behavioral and psychological symptoms of dementia among caregivers working
at facilities without medical specialists and/or registered nurses.
Methods: A cluster quasi-randomized, controlled comparative trial was carried out at 17 facilities in Japan. Our
intervention was an educational program administered at baseline using printed educational material for the care staff.
The primary outcome was evaluated using the Japanese version of the Neuropsychiatric Inventory Questionnaire. The
secondary outcome measures were caregiver burnout evaluated using the Japanese version of the Maslach Burnout
Inventory and the care dependency of residents measured using the Japanese version of the Care Dependency Scale.
Results: The total Neuropsychiatric Inventory Questionnaire score decreased signiﬁcantly in the intervention
group (F  = 6.57, P = 0.01), and the difference between the intervention and control groups was also signiﬁ-
cant (F  = 4.78, P = 0.03). There were no signiﬁcant changes in the Maslach Burnout Inventory or Care
Dependency Scale scores in the intervention group, while the Maslach Burnout Inventory subscale (personal accom-
plishment) score decreased signiﬁcantly in the control group.
Conclusions: Our intervention achieved a signiﬁcant reduction of distress among caregivers working at care
homes without medical specialists and/or registered nurses. The ﬁndings of this research show that educational
intervention can make a valuable contribution to training programs for care staff. Geriatr Gerontol Int 2018; 18:
Keywords: behavioral and psychological symptoms of dementia, care facilities, distress, printed educational
People with dementia can develop a wide range of
behavioral and psychological symptoms of dementia
which arise in 90% of dementia patients at
some point in their course and are common in care
BPSD are an important source of psychologi-
cal distress and care burden for caregivers.
of the residential aged care facilities in Japan, there are
few doctors and/or nurses specializing in dementia care.
Thus, BPSD can easily become a problematic issue at
Various interventions for alleviating the burden of
caring for dementia patients have been studied.
Accepted for publication 19 September 2017.
Correspondence: Dr Koji Fukuda MD, PhD, Department of
Psychiatry, National Center for Geriatrics and Gerontology,
Morioka 7-430, Obu City, Aichi 474-8511, Japan.
doi: 10.1111/ggi.13207 |© 2017 Japan Geriatrics Society
Geriatr Gerontol Int 2018; 18: 487–494