Factors associated with short-term institutionalized nursing care among first-time users of home-visit nursing stations in rural Japan

Introduction: A detailed study of long-term care insurance service selection and use should provide suggestions for medical policies regarding future care of the elderly in Japan. In this study, we examined factors related to the use of short-term institutionalized nursing care (hereinafter, "short stay") by first-time users of home-visit nursing stations. Methods: Subjects were 103 individuals who were first-time users of home-visit nursing stations in A city, located in a rural prefecture in Japan. The survey was conducted between 2009 and 2014 and comprised items on characteristics, including whether or not they used short stay services, and the Japanese version of the Zarit Burden Interview (J-ZBI). Responses were collected by home-visit nurses. For analysis, subjects were divided into two groups depending on whether or not they used short stay services. We compared both the characteristics and J-ZBI scores of short stay users and non-users through statistical analyses. We analyzed the Personal Strain, Role Strain and total scores of the J-ZBI according to the use of short stay services. Results: The mean age of individuals in need of long-term care was 64.2 ± 10.1 years in the short stay user group and 69.3 ± 10.6 years in the non-user group, indicating a significant difference (P = 0.017). Twenty-five subjects in the user group and 21 subjects in the non-user group had a primary caregiver who worked (P = 0.019). A sub-caregiver assisting the primary caregiver was present for 47 subjects in the non-user group and only 25 subjects in the user group (P = 0.027). The total J-ZBI score was 37.7 ± 15.7 in the user group and 27.8 ± 15.5 in the non-user group (P < 0.01). According to logistic regression analysis, short stay users were positively associated with the Personal Strain, Role Strain and total scores of the J-ZBI, and were negatively associated with age. Conclusion: Our study suggested that younger first time users of home-visit nursing stations in rural Japan often use short stays as a result of understanding the burden on their caregiver.