Analysis of Latent Factors Underlying Conceptions of People with Dementia and the Effects of Social Resources

Analysis of Latent Factors Underlying Conceptions of People with Dementia and the Effects of Social Resources. Biomed J Sci & Tech Res 39(2)-2021. BJSTR. MS.ID.006271. Background: As policies aimed at deepening the understanding of dementia have become a global issue, to reduce the stigma of the condition and to realize a society of symbiosis, we will clarify the conceptions that the general public have about people with dementia. We will also examine the effects that existing initiatives and social resources have on public understanding of people with dementia. Methods: In this study, we prepared 18-item questionnaire polling respondents’ conceptions of people with dementia and conducted an attitude survey using this questionnaire among 12,410


Introduction
Against the backdrop of Japan's fast-declining birth rate and growing-ageing population, support measures for people with dementia, estimated to be around 7 million in 2025, are drawing attention. In the Dementia Policy Promotion Outline promulgated by the Ministry of Health, Labour and Welfare in June 2019, 'symbiosis' is listed as a pillar, and 'dissemination and enlightenment / personal dissemination support' is listed as Factor 1 in the section on specific measures [1]. This can be interpreted as a message that we must deepen our understanding of dementia to ensure that people with dementia and their families can continue living in their own way in their communities. Globally, many OECD countries have designated the promotion of dementia awareness as a preeminent national strategy for supporting dementia. In the 2019 World Alzheimer Report released by the International Association for Alzheimer's Disease, the need to reduce stigma for people with dementia was strongly emphasized, and 10 recommendations were proposed [2]. These recommendations include the creation of communities that are kind to people with dementia and to practice person-centred care. In other words, these recommendations encourage people to cultivate positive conceptions about dementia, and countries throughout the world are being asked to create policies that deepen understanding and awareness of the condition. On the other hand, one of the primary factors hindering understanding of dementia is 'stigma'. Byrne describes stigma as a discriminatory attitude toward or negative outlook on the conspicuous or unusual characteristics or traits of individuals [5].

Person-Centred Care & Stigma
The World Alzheimer Report 2019 cites the existence of stigmas as a major obstacle to both the provision of dementia-related information to those that seek it and the delivery of care and support to those that need it [2]. In the 2013 'G8dementia Summit', the 11 th item of the Global Action against Dementia agenda was the strengthening of efforts to lessen stigma towards dementia [6]. Kudo has conducted analyses of stigmas toward people with dementia in Japan and pointed out that when it comes to supporting them, their surrounding environment-especially their relationships with other individuals-is particularly important, and that stigma serves as an obstacle to early community detection of and intervention for people with dementia [7]. In the same paper, Kudo lists behavioural impairment among people with dementia, lack of knowledge of the condition itself, and anxieties about one's own future condition as factors connected to dementia-related stigma. Removing these stigmas is not an easy task. Since they are often rooted in the history and culture of a nation or region, rather than proposing sweeping policies to counteract dementia-related stigma, the idea of stigma reduction itself should be hoisted as a global directive, and communities should work at the local level to encourage and deepen dementia awareness.

Hypothesis and Study Purpose
The two opposing concepts described above represent the we used the results of the "Survey of General Public Attitudes toward Dementia," which was part of that survey, to conduct our analysis. As we test the aforementioned hypothesis, the objective of this study is to clarify the conceptions of people with dementia and to ascertain how existing initiatives and social resources affect dementia understanding and awareness among the general public.

Materials and Methods
The details of the attitude survey (questionnaire format) used in this study are provided below.

Questionnaire Survey Procedure
With the cooperation of AAJ chapters in the 47 administrative districts of Japan, the survey was carried out by targeting attendees and participants of public events held by each chapter, including lectures, university festivals, community events, elderly persons' clubs, and dementia cafés. The survey was administered by AAJ staff members, and staff members/research collaborators periodically collected responses and sent them back to the main research office.

Content of Attitude Survey
The attitude survey polled respondents on their basic attributes Hirotani [13], and Yamada [14] (Table 1). Participants were asked to respond to the following question items using a 4-point scale (1. Agree 2. Somewhat agree 3. Somewhat disagree 4. Disagree).

12
Understanding by surrounding people is very important in dementia.

13
It is good for people with dementia to participate in community activities.
14 It is possible to share happiness and enjoyment with people with dementia.

15
People with dementia has ups and downs, and when "up," they can live normally. 16 It is important to be lenient with people with dementia listen to what they have to say.

17
People with dementia are often in a state of mental turmoil or anxiety.

18
People with dementia are probably optimistic and not much trouble.

Results
The results of the attributes (age, gender, occupation) of the 10,485 analysed respondents are shown in (  (Table 3). The results of our exploratory factor analysis of answers to questions regarding conceptions of people with dementia are shown in (Table 4). The four items whose communality fell below 0.3 during the factor analysis process [question items (7), (9)    Welch's t-test was adopted to compare the two groups (four items), and Welch's test was also adopted for analysis of variance among the three groups (one item). First, a significant difference in mean PC score was observed between the two groups: Had and had not attended a dementia supporter training course. Significant differences were also observed for high-and low-awareness groups for long-term care insurance awareness, Dementia café awareness, and AAJ awareness. Finally, a one-way ANOVA test between the three groups divided by (5) level of experience with people with dementia also revealed significant differences. The results are presented in (Table 5).

Conceptions of People with Dementia
In this study, the first stage of our factor analysis revealed the It is also interesting that 'unknown anxiety' exists as a latent factor in the conceptions of people with dementia. While this can be interpreted as a negative factor, but this can be seen as a negative factor, but it is also a result of the information confusion that has surfaced as Japan faces the social challenge of an aging population.
In our highly advanced information-oriented society, most media sources depict ageing as a problem to be solved. Identifying correct information and determining what people needs to understand is particularly difficult in modern society, in particular, individuals that do not normally interact with elderly persons can have limited opportunities to experience dementia proximally, and negative conceptions pushed by media narratives take precedence. Ogawa holds that a deep understanding and acceptance of people with dementia are necessary for the realization of an inclusive society (a 'dementia-friendly community') [17], and it is not difficult to imagine how 'unknown anxiety' could serve as an obstacle to such a goal. We hope that it will eventually become commonplace for individuals to be fully informed of and understand how to properly interact with them.

Factors Affecting Positive Conceptions of Dementia
The second stage of our factor analysis involved using tests of mean difference to analyse the effects of using and awareness of interact with people with dementia will foster a sense of personcentredness.
While determining how and when to set up these opportunities for both groups to interact with one another is a project for the future, unbiased information provision (education) that takes place before stigmas can take hold is necessary. We believe that the findings obtained through this study will be important for future policy considerations for promoting dementia understanding and awareness. Changing the stigmas in people's hearts to positive conceptions will undoubtedly lead to the early discovery of dementia and the realization of warm, personable care environments. Therefore, it will be necessary to continue to examine the meaning and impact of existing measures, such as dementia supporter training courses, and awareness-raising activities for understanding dementia in society in Japan. In addition, greater use of social resources aimed at dementia awareness or expanded educational efforts to teach individuals about people with dementia will help us understand the condition as one that is very proximal to all members of society, and will help grow a society rich in personcenteredness. Against such a backdrop, people with dementia will also have more opportunities to enter and engage with society, thereby growing person-centredness of people further. To truly realize a society of symbiosis with dementia, we must work to create a positive cycle that heightens our levels of person-centredness.

Limitations of this Study and Future Issues
The data we analysed in this study was based on a survey conducted at events where the elderly was relatively likely to participate, and some of the responses included those from medical and welfare professionals. Therefore, there was a possibility that some of the respondents already had an interest in dementia.
Future research needs to understand the views of those who do not have preconceived notions about dementia in order to further explore the reality of stigma against people with dementia. In addition, since this study is a cross-sectional study, we cannot deny that there is a reverse causal relationship between the use and knowledge of social resources for dementia understanding and experience interacting with people with dementia raised PC scores.
These points will be mentioned as limitations of this study at the end.