| Project/Area Number |
03454509
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Nursing
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| Research Institution | Tokyo Metropolitan Institute of Gerontology |
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Principal Investigator |
SHICHITA Keiko Tokyo Metropolitan Inst. of Gerontology, Depertment of Nursing, 看護学部門, 室長 (80072990)
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| Co-Investigator(Kenkyū-buntansha) |
YABE Hiroko Tokyo Women's Medical College Junior College of Nursing, Lecturer, 看護短期大学, 講師 (60220216)
MAKITA Fuki Tokyo Metropolitan Inst. of Gerontology, Depertment of Nursing, Research Scienti, 看護学部門, 研究員 (90219303)
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| Project Period (FY) |
1991 – 1993
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| Project Status |
Completed (Fiscal Year 1993)
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| Budget Amount *help |
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 1993: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1992: ¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 1991: ¥1,300,000 (Direct Cost: ¥1,300,000)
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| Keywords | Dementia / Assessment / Health conditions / Subjective symptoms / Objective symptoms / Physical symptoms / Mental symptoms / 評価法 / 健康状態変化 / 生活変化 / ケア / 問題行動 |
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| Research Abstract |
The purpose of the present study was to seek early manifestations which were relevant to adequate nursing care. A nurse has to detect, interpret and respond to physical abnormalities without delay. Expereienced nurses usually respond to new events inconsciously. We therefore attempted to collect and analyze ways of identification and interpretation of changes in health conditions of old persons with dementia, reported by nurses and also to identify clinical items which require nurse's attention and action. 1) We reviewed nursing records of hospitalized patients in a geriatric hospital listing mental and physical symptoms and nurse's reactions to them. 2) We held workshops on nurse's interpretation of symptomatology and their responses. 3) We compared confirmed diagnosis and initial manifestations and complaints of elders with dementia at the admission from medecal records of hospitalized patients.
Deterioration of health was manifested by general symptoms such as facial out-look, frequencies of conversations, the level of consciousness, daily activities, changes in general conditions. It manifested as changes in daily life such as apathy, decrease in conversation and lack of movement rather than somatic abnormalities. Initial symptoms at the admission included objective symptoms such as difficulty in walking, bloody stool or genital excreta, fever, stridor, chocolate-colored stool, fall and breathlessness, rather than subjective complaints, probably because of difficulty in accurate communications on symptoms. Family tended yo hesitate and postpone medical consultations until further worsening of objective symptomatology.
We conclude that patients with dementia scarcely complain subjective symptoms and a nurse or caregiver must always make careful observations on objective symptoms, general features and changes in daily life of the elders with dementia and try to make their assessment for proper nursing.
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