The relationship between care workers' exposure to dementia-related aggressive behavior and occupational stress in Japan: a mixed-methods

Aggressive behaviors (ABs) in dementia care increase occupational stress and may contribute to staff turnover, yet little research exists in Japan where cultural norms may shape responses. This mixed-methods, cross-sectional study translated and validated the Japanese Exposure to Disruptive Behavior scale and surveyed 137 care workers in dementia units across 10 nursing homes. Higher exposure to ABs was associated with greater job burnout and intention to resign, while caregiving for dependents showed no effect. Qualitative responses highlighted cultural values and perceptions of ABs as stress-related or linked to care quality. Findings support culturally tailored training to reduce ABs and occupational stress.