Application of horticulture therapy as a health intervention for elderly people in nursing homes:a scoping review

Objective:To review the scope of interventional studies on horticultural therapy(HT)applied to elderly people in nursing institutions to support the efficient implementation of HT among this target group.Methods:In accordance with the scoping review framework proposed by the Joanna Briggs Institute(JBI),the Pub Med,JSTOR,Web of Science,CNKI,and Wanfang databases were searched.Data from the retrieved literature were summarized and analyzed.Results:In all,18 studies were included in this review.The target population groups of interventions included self-supporting elderly people,cognitively impaired elderly people,elderly people with negative emotions,and elderly people with frailty living in nursing institutions.HT interventions,including planting,craft activities,derivative activities,and outdoor viewing activities,are implemented indoors,outdoors,or in mixed settings.The most common duration of the intervention was 8 weeks,the most common frequency was once per week,and the most common session duration was 60 min.Conclusions:The measurements used in HT interventions included assessments of physical,psycho-mental,and social health;quality of life;and activity effects.Future studies should include partially dependent groups and completely dependent groups of elderly individuals,interventions that last at least 6 months,scientifically designed activity intensity and safety-guarantee plans,and outcomeevaluation indicators such as compliance and intervention benefits.

Current research on alexithymia in elderly people in nursing institutions: a scoping review

To describe and analyze the research status of alexithymia in elderly people in nursing institutions,and summarizes the existing research results and shortcomings.The literature in PubMed,CochraneLibrary,Web of Science,EBSCO,Proquest,Scopus,Sinomed,CNKI,WanFang,VIP was computer searched,and the time frame was build to October 30,2023.A total of 15 articles were included,comprising 10 in Chinese and 5 in English.Among them,14 articles were cross-sectional studies reporting the prevalence and influencing factors of communication disorders in elderly people residing in nursing homes.A total of three assessment tools were used.Additionally,three articles described preventive or intervention measures targeting alexithymia.Alexithymia has a high incidence and severity among elderly individuals in nursing institutions.Currently,there are only a few assessment tools available,and experimental studies are notably scarce.Future research should focus on enhancing the understanding of alexithymia in this population by developing and validating more comprehensive assessment tools,diversifying research methodologies,and conducting intervention studies that consider the various influencing factors.

Sleep quality in middle-aged and elderly hemodialysis patients:Impact of a structured nursing intervention program

BACKGROUND Poor sleep quality is common among hemodialysis patients and can significantly impact their well-being.This study aimed to evaluate the effectiveness of a structured nursing intervention program in improving sleep quality in middleaged and elderly hemodialysis patients.AIM To evaluate the impact of nursing intervention on sleep quality in hemodialysis patients.METHODS This cross-sectional study was conducted in a tertiary hospital,the First Affiliated Hospital of Nanchang University,in 2023.This study included 105 middle-aged and elderly hemodialysis patients aged≥45 years who underwent maintenance hemodialysis for at least 3 mo,utilizing the Pittsburgh Sleep Quality Index(PSQI)to identify poor sleepers.Those identified underwent a 12-wk nursing intervention program focusing on education,relaxation techniques,and counseling.Post-intervention,sleep quality was reassessed using the PSQI.RESULTS The study found that 68.6%of hemodialysis patients were poor sleepers.Following the 12-wk nursing intervention program,there was a significant decrease in the mean global PSQI score from 8.9±3.2 to 5.1±2.7(P<0.001),indicating improved sleep quality.This demonstrated the effectiveness of the structured nursing intervention in enhancing sleep quality for middle-aged and elderly hemodialysis patients.CONCLUSION The structured nursing intervention program focusing on sleep hygiene education,relaxation techniques,and counseling effectively improved sleep quality among middle-aged and elderly hemodialysis patients.The significant decrease in the mean global PSQI score post-intervention indicates the positive impact of tailored nursing interventions in addressing poor sleep quality in this patient population.These findings emphasize the importance of implementing targeted nursing interventions to enhance the quality of life for hemodialysis patients by addressing the prevalent issue of poor sleep quality.

Analysis of the Nursing Effect of Continuity of Care on Elderly Patients with Coronary Heart Disease Unstable Angina and its Impact on Quality of Life

Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.

Analysis of The Effect of Comprehensive Nursing Intervention on Improving Blood Sugar Levels and Treatment Compliance in Elderly Patients with Diabetes

Objective: To analyze the effect of comprehensive nursing intervention on improving blood glucose levels and treatment compliance in elderly patients with diabetes. Methods: One hundred and forty-eight elderly patients with diabetes were selected and randomly divided into a control group and an observation group, with 74 cases each. The control group received routine nursing intervention and the observation group received comprehensive nursing intervention. The blood sugar levels, treatment compliance, and nursing satisfaction of the two groups of patients before and after intervention were compared. Results: After the intervention, the fasting plasma glucose (FPG) (t = 7.729), 2 hours postprandial glucose (PPG) (t = 8.343), and HbA1c (t = 6.929) levels of patients in the observation group were significantly lower than those in the control group (P < 0.001). The observation group (71/95.95%) had a higher compliance rate than the control group (54/72.97%) (χ^(2)=14.877, P < 0.001). The comprehensive nursing satisfaction rate of the observation group (73/98.65%) was higher than that of the control group (56/75.68%) (χ^(2)=17.451, P < 0.001). Conclusion: In caring for elderly patients with diabetes, comprehensive nursing intervention effectively reduced patients’ blood sugar levels and improved treatment compliance and nursing satisfaction.

Coping review of dementia fear studies among middle-aged and elderly people in the community

This study used Arksey and O’Malley’s scoping review methodology as a framework and searched the following databases:PubMed,Embase,EBSCO,CINAHL,Web of Science,Cochrane Library,Scopus,CNKI,Wanfang,VIP,and the Chinese Biomedical Literature Database.The database is open to December 20,2023,and documents related to the fear of dementia among the elderly in the community are described and analyzed to provide a reference for future research in this field.At the same time,we screened,extracted,and summarized relevant information from 21 included documents(16 in English and 5 in Chinese),which consisted of 16 cross-sectional studies,2 quasi-experimental studies,2 randomized controlled studies,and 1 longitudinal study.Sixteen of the included documents mentioned the incidence or level of dementia fear among the elderly in the community,2 addressed the adverse effects of dementia fear,and 4 reported prevention and intervention measures for dementia fear.In total,there are 8 assessment tools,and the influencing factors are categorized into sociodemographic characteristics,psychological and behavioral characteristics,sociocultural background factors,and health and dementia-related factors.The final conclusion is that the fear of dementia is common among the elderly in the community.In the future,the application of research tools should be expanded among middle-aged individuals,with considerations for other types of dementia in mind.It is recommended to conduct large-scale,multi-center randomized controlled trials while confirming the intervention’s effect on different types of middle-aged and elderly individuals,focusing on the long-term impact of these intervention measures to promote healthy aging.

Virtual Nursing Using Deep Belief Networks for Elderly People (DBN-EP)

The demand for better health services has resulted in the advancementof remote monitoring health, i.e., virtual nursing systems, to watch and supportthe elderly with innovative concepts such as being patient-centric, easier to use,and having smarter interactions and more accurate conclusions. While virtual nursing services attempt to provide consumers and medical practitioners with continuous medical and health monitoring services, access to allied healthcare expertssuch as nurses remains a challenge. In this research, we present Virtual NursingUsing Deep Belief Networks for Elderly People (DBN-EP), a new framework thatprovides a virtual nurse agent deployed on a senior citizen’s home, workplace, orcare centre to help manage their health condition on a continuous basis. Using thismethod, healthcare providers can assign various jobs to nurses by utilizing a general task definition mechanism, in which a task is defined as a combination ofmedical workflow, operational guidelines, and data gathered from a remotelymonitored virtual nursing system. Practitioners are in charge of DBN-EP andmake treatment decisions for patients. This allows a DBN-EP to act as a personalized full-time nurse for a client by carrying out practitioner support activitiesbased on information gathered about the client’s health. An electronic PersonalHealth Record (ePHR) system, such as a specialized web portal and mobile apps,could provide such patient information to elderly person family members and carecentres. We created a prototype system using a DBN-EP system that allows traditional client applications and healthcare provider systems to collaborate. Finally,we demonstrate how this system may benefit the elderly through a result anddebate.

Utility of “loco-check,” self-checklist for “locomotive syndrome” as a tool for estimating the physical dysfunction of elderly people

Aim: A new concept of locomotive syndrome has been proposed by the Japanese Orthopaedic Association. The aim of this study is to clarify the utility of its self-checklist, “loco-check,” as a tool for estimating the physical dysfunction of elderly people. Methods: Subjects were 1124 community-dwelling Japanese people, 557 men and 567 women, aged 40-89 years. Information about the seven “loco-check” items was obtained from present inquiry sheets. Physical functions were examined by grip strength, knee extension strength, walking speed and one-leg standing time with open eyes. The averages of these test values, controlled for age and BMI, were compared between the “loco-check” (+) group and the “loco-check” (-) group. Also we examined about the trend of decline of physical function, together with SF36 physical function subscale score, as the number of the items chosen increased. Results: Adjusted average values of all four physical function examinations in the “lococheck” (+) group were significantly lower than those of the “loco-check” (-) group (all, p . Also the adjusted average values of the majority of four tests were significantly lower in those who checked each of the “loco-check” items than those who did not, for most of the items. It was also revealed that the more items subjects checked, the lower the adjusted average values were, except for one-leg standing time. It was also the case with SF36 physical function subscale score. Conclusion: We showed the utility of “loco-check” as a simple tool not only for noticing the physical dysfunction of elderly people, but also for estimating the extent of it, except for balancing ability, particularly by counting the number of checked items.

Can statins reduce risk of lung cancer,especially among elderly people? A meta-analysis

Objective： As the most common cause of cancer mortality throughout the world, lung cancer has drawn people＇s attention on how to reduce the risk with chemopreventive ways. Many epidemiological studies have shown inconsistent effects of statins on lung cancer, but some observational studies have showed that statins had protective effect on lung cancer among elderly people. So we preformed this meta-analysis to find whether statins were chemopreventive. Methods： We searched MEDLINE, EMBASE and Web of Science databases from inception to September, 2013. A total of 23 studies were selected, including 15 observational studies and 8 randomized controlled trials （RCTs）. Both fixed and random-effects models were used to calculate pooled estimates in primary and sensitivity analyses. We used Q and 12 statistics to assess statistical heterogeneity, and evaluated publication bias by Begg＇s test and Egger＇s test. Results： No association between statins and lung cancer risk was identified either in the meta-analysis among RCTs [relative risk （RR）： 0.95, 95% confidence interval （95% CI）： 0.85-1.06] or observational studies （RR： 0.89, 95% CI： 0.77-1.04）. We also selected 6 observational studies that all researched on elderly people. The result of meta-analysis showed that there was still no protective effect between statins and lung cancer among elderly people （RR： 1.03, 95% CI： 0.96-1.11）. Conclusions： Our results did not support a protective effect of statins on the overall lung cancer risk and the lung cancer risk among elderly people. More well-designed RCTs are needed to enhance our understanding of the chemopreventive effect of statins on lung cancer.

Quality of life and hope in elderly people with cancer

The aim of this study was to describe the charac-teristics in Quality of Life (QoL) and hope in eld-erly people newly diagnosed with cancer, and to compare the results for those who survived six months after diagnosis with those who did not. The design of the study was a quantitative study in-cluding drop-out analysis. Data were collected pro-spectively from a group of 101 older people with cancer. The core questionnaire EORTC QLQ-C30 was used to measure QoL and Nowotny’s Hope Scale (NHS) was employed to measure hope. Par-ticipants who died within six months of diagnosis had significantly lower QoL and had more com-plaints about symptoms compared to those who survived. However, hope did not differ significantly between those who died and those who survived. Despite lower QoL score among those who died they were able to deal with their difficult situation and maintain hope in late life. This capacity seems to be an important component of hope in the elderly;thus it is essential to strengthen hope.

Application of a perioperative nursing strategy in the surgical treatment of elderly patients: a narrative review

With the steady increase of older people in society, a progressively greater number of patients belonging to the geriatric group need surgical treatment. Since elderly patients with reduced physiological reserve and organ failure often have chronic diseases, geriatric syndrome, and other clinical problems, the perioperative nursing of elderly patients is more complicated. Therefore, we need to comprehensively consider clinical issues, such as patients’ preoperative status, surgical risks, and postoperative quality of life and life expectancy, and conduct comprehensive evaluations and holistic, individualized, and continuous nursing and therapy through the participation of interdisciplinary teams to achieve better curative effects. Here, the perioperative nursing of elderly patients is reviewed, including preoperative evaluation and nursing, intraoperative management, and postoperative nursing.

Intelligent Video Surveillance System for Elderly People Living Alone Based on ODVS

Intelligent video surveillance for elderly people living alone using Omni-directional Vision Sensor (ODVS) is an important application in the field of intelligent video surveillance. In this paper, an ODVS is utilized to provide a 360° panoramic image for obtaining the real-time situation for the elderly at home. Some algorithms such as motion object detection, motion object tracking, posture detection, behavior analysis are used to implement elderly monitoring. For motion detection and object tracking, a method based on MHoEI(Motion History or Energy Images) is proposed to obtain the trajectory and the minimum bounding rectangle information for the elderly. The posture of the elderly is judged by the aspect ratio of the minimum bounding rectangle. And there are the different aspect ratios in accordance with the different distance between the object and ODVS. In order to obtain activity rhythm and detect variously behavioral abnormality for the elderly, a detection method is proposed using time, space, environment, posture and action to describe, analyze and judge the various behaviors of the elderly in the paper. In addition, the relationship between the panoramic image coordinates and the ground positions is acquired by using ODVS calibration. The experiment result shows that the above algorithm can meet elderly surveillance demand and has a higher recognizable rate.

Measuring the Cognitive Impact of Laughter on Elderly People with Mild Cognitive Impairment in Japan

Objective: To evaluate the effect of laughter on cognition in elderly with mild cognitive impairment (MCI) through an appropriately designed intervention. Methods: The intervention involved watching a Japanese comedy routine (Manzai) for approximately twenty minutes, once a week for ten weeks. Participants were asked to paint, as a simple exercise, in addition to watching the show. Twenty-seven patients with MCI from the convalescent ward of a general hospital in the Kansai region of Japan. We measured cognition by evaluating five cognitive function domains before (baseline) and after the intervention. We used the Wilcoxon signed rank test, a distribution-free method, to compare baseline and post-intervention data. Ethical Consideration: Participants were given a document explaining the study. Only those who officially agreed to participate were enrolled. Results: Mean age of patients was 85.0 ± 2.8 years;average education was 8.6 ± 2.8 years. Three cognitive function domains had significantly different average scores after the intervention: 1) Exercise: 44.4 ± 8.9 points at baseline, 36.3 ± 10.2 post-intervention (p = 0.014);2) Word memory: 40.6 ± 7.2 at baseline, 43.1 ± 8.8 post-intervention (p = 0.002);and 3) Animal name recollection: 35.3 ± 8.4 at baseline, 38.1 ± 9.0 post-intervention (p = 0.003). Discussion: The intervention led to significantly higher cognitive scores in exercise, word memory, and animal name recollection domains, suggesting that interventions focused on laughter and simple exercise may improve cognition in elderly patients with MCI.

A randomized controlled trial of group mindfulness therapy on sleep quality of the elderly in nursing homes

Background:Poor sleep quality of the elderly in nursing homes will reduce the quality of life,which needs to be treated properly.The purpose of the study is to investigate the effect of group mindfulness therapy on sleep quality of the elderly in nursing homes.Methods:A parallel randomized controlled trial was used in this study.The semi-structure interview and the mindfulness therapy intervention was used as the intervention.The Pittsburgh sleep quality index scale and Glaizzi phenoenological data for a 7-step was used to analyze the results.Results:After 8 weeks of intervention,the sleep quality of elderly people was improved to a certain extent(P<0.05).Our investigation showed that some elderly people think that through this kind of training they had reduced the frequency of taking sleeping pills.Conclusion:Group mindfulness therapy could improve sleep quality to some extent.

Blood Glucose Sensor Systems for Elderly People

Electrochemical blood glucose sensors were developed with use of enzymes and an electron mediator.Electrodes were patterned on a resin plate,and a reagent layer containing an enzyme and an electron mediator was disposed on the electrodes in a dried state.A sample chamber to which the soluble reagent layer was exposed was assembled with the enzyme-loaded electrodes to hold a certain volume of blood in the sensor.The fabricated sensors enabled rapid and precise measurements of blood glucose of oneself.The sensor systems combined with the customized hand-held meter especially for the sensor were maintenance-free chiefly due to disposable sensors,and would be simple and easy enough to be operated by elderly people.

Effectiveness and safety of subthreshold vibration over suprathreshold vibration in treatment of muscle fatigue in elderly people

Muscle fatigue is common in many populations,particularly elderlies.Aging increases the incidence of muscle fatigue and delays its recovery.There is a huge debate about the current treatments for muscle fatigue,particularly in elderlies.Recently,it has been discovered that mechanoreceptors have an important role as a sensory system in sensing muscle fatigue which could enhance the body's response to muscle fatigue.The function of mechanoreceptors could be enhanced by applying either suprathreshold or subthreshold vibration.Although suprathreshold vibration improves muscle fatigue,it can cause desensitization of cutaneous receptors,discomfort,and paresthesia,which are barriers to clinical use.Subthreshold vibration has been approved as a safe and effective method of training for mechanoreceptors;however,its use and effectiveness in muscle fatigue have never been tested or explained.Possible physiological effects of subthreshold vibration in the treatment of muscle fatigue include:(1)Enhancing the function of mechanoreceptors themselves;(2)Increasing the firing rate and function of alpha motor neurons;(3)Increasing blood flow to fatigued muscles;(4)Decreasing the rate of muscle cell death in elderlies(sarcopenia);and(5)Driving motor commands and allow better performance of muscles to decrease fatigue incidence.In conclusion,the use of subthreshold vibration could be a safe and effective treatment for muscle fatigue in elderlies.It could enhance recovery from muscle fatigue.Finally,Subthreshold Vibration is safe and effective in treating muscle fatigue in comparison to suprathreshold vibration.

Assessment of the Level of Knowledge, Attitude, and Practice with Regard to Care of People Living with HIV/AIDS among Nursing and Midwifery Students in Fako, Cameroon

Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.

The Impact of a Multidisciplinary Nursing Model on the Quality of Life of COPD Patients in Remission in the Elderly

Objective:To study the effects of multidisciplinary nursing model on self-care ability,lung function,exercise endurance,negative emotion and quality of life of elderly patients with chronic obstructive pulmonary disease(COPD).Methods:80 patients with COPD hospitalized in the Aerospace Center Hospital from August 2019 to August 2020 were recruited.They were randomly divided into control group and experimental group,with 40 patients in each group.The patients in the control group received routine nursing,and the patients in the experimental group received multidisciplinary nursing intervention on the basis of routine nursing.The nursing observation time of the two groups was 8 weeks.Results:after 8 weeks of nursing intervention,it was found that FEV1/FVC and 6MWD in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in SAS score and SDS score between the two groups before nursing,but it was significantly lower in the observation group after nursing.The difference between the above data was statistically significant(P<0.05).The SGRQ score of the observation group was significantly lower than that of the control group(P<0.05).Conclusion:the application of multidisciplinary nursing model can effectively improve the exercise endurance of elderly patients with COPD,eliminate the negative emotions of patients,and improve the quality of life of patients.The comprehensive application value is significant.

Development of a questionnaire assessing nursing staff’s knowledge,attitude,and practice on the prevention of the nosocomial infection in elderly patients:testing reliability and validity

Objective:To develop a questionnaire assessing nursing staff’s knowledge,attitude,and practice on the prevention of the nosocomial infection in elderly patients and test its reliability and validity.Methods:After the drafted questionnaire was developed,two rounds of Delphi survey were conducted by consulting experts to improve the questionnaire.Subsequently,700 copies of the questionnaire were distributed to nursing staff to assess its reliability and validity.Results:Exploratory factor analysis(EFA)identifies 3 aspects,namely knowledge,attitude,and practice,with a total of 38 items.The Cronbach’s a coefficients of the questionnaire and each of the aspects are 0.85,0.80,0.886,and 0.77(>0.7),respectively.Confirmatory factor analysis(CFA)of each of the aspects are c2/df=3.99,2.26,and 3.32;Goodness-of-fit index(GFI)=0.91,0.97,and 0.92;Root mean square error of approximation(RMSEA)=0.06,0.04,and 0.05;Comparative fit index(CFI)=0.91,0.96,and 0.90.Conclusions:Through this study,it can be ascertained whether the developed questionnaire enjoys sound reliability and validity in assessing nursing staff’s knowledge,attitude,and practice on preventing the nosocomial infection in elderly patients and thus has certain application value.

Comparison of Factors Related to Elderly People’s Purpose of Life in Japan and Thailand

Purpose: In the present study, the features of “purpose of life” of elderly persons in Japan and Thailand are clarified by focusing on this concept and its related factors, and through the comparison of the results of Japan and Thailand. Methods: The Japanese subjects consist of the elderly aged 60 or older. The Thai subjects consist of the elderly aged 60 or older who live in Thailand. A sum of 250 subjects (men and women) per country will be studied. They were asked about their individual attribution and maintenance of healthy condition. Moreover, 19 items were examined as events leading to life purpose. These items were measured using the Philadelphia Geriatric Center Morale Scale, General Health Questionnaire (GHQ) and Instrumental Activities of Daily Living (IADL). Results: Data from 200 elderly people (male: 67, female: 133) in Thailand and 234 elderly people (male: 49, female: 185) in Japan were used in the analysis. Regarding an “Events Leading to Life Purpose,” it was suggested that “activities to enhance learning and culture” and “neighbors and friends, and socializing with acquaintances” helped both in Japan and Thailand. Moreover, “elderly persons’ club activities” and “child” were effective in Thailand, while “spouse” and “grandchild” were effective in Japan. Moreover, Model 1 (event, disease → purpose of life → mental health, and IADL) that became purpose of life for both countries was adopted. Conclusion: In order to improve older adults’ mental health and ADL by improving “purpose of life”, it is required to increase the events leading to life purpose and to prevent illness for both countries. In particular, “activities to enhance learning and culture” and “neighbors and friends, and socializing with acquaintances” was the activity which raises “purpose of life”. Then, “elderly persons’ club activities” and “child” were effective in Thailand, while “spouse” and “grandchild” were effective in Japan.