| Co-Investigator(Kenkyū-buntansha) |
HISANO Nobuko University of Miyazaki, Miyazaki Medical College, Reader, 医学部, 助手 (40253760)
YAMADA Miyuki University of Miyazaki, Miyazaki Medical College, Reader, 医学部, 助手 (00336314)
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| Budget Amount *help |
¥2,000,000 (Direct Cost: ¥2,000,000)
Fiscal Year 2003: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 2002: ¥1,000,000 (Direct Cost: ¥1,000,000)
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| Research Abstract |
The aim of this study is to clarify the roles of nurses at specialized nursing homes for the elderly requiring terminal care and to identify factors that can enrich terminal care. A questionnaire was sent to 1.000 specialized nursing homes for the elderly requiring care in Japan, and one person from each nursing home filled out the questionnaire and returned it to us by mail in the year 2002. Return rate was 43.3%. The average number of inpatients in each nursing home was 67.0 ± 24.8, and the average age was 84.0 ± 1.9. The average number of deceased in year 2001 was 10.3 ± 5.9, and out of that, 4.3 ± 5.2 persons died in nursing home. The inpatients more than 91 years old who died in nursing homes in year 2001 accounted for the most 32.9%, and the inpatients 86-90 years old accounted for the next most 28.0%. The diseases that caused the death of inpatients in nursing homes were first senile decay (33.3%), second heart disease (21.6%) and third pneumonia (18.6%). Each nursing home had 0
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.06 ± 0.2 full-time physicians, 1.5 ± 1.4 registered nurses and 2.1 ± 1.4 practical nurses. The rate of practical nurses was high, and 26.6% of nursing homes had not full-time registered nurse at all. 9.8% of nursing homes gave the night shift service of nurses. In terminal care, all of 52 medical practices were given, and 48 items of them were chiefly practiced by nurses. Persons other than medical staff practiced also 33 medical practices. The works for which nurses spent much time in terminal care were first "observation and comprehension of conditions" (65.8%), second "medical practice" (57.5%) and third "support of everyday life" (46.2%). The problems nurses faced in medical cares were how to cooperate with family (11.8%), how to cooperate with physicians (11.6%), working system of nurses (10.5%) and care workers' good understanding about terminal care (9.7%).
In year 2003, a questionnaire was sent once more to 800 out of 1000 specialized nursing homes for the elderly requiring terminal cares in the previous year, and one physician, one nurse and one care worker in each nursing home filled out the questionnaire and returned it to us by mail. Return rate was each 14.8%, 28.5% and 27.0%. In regard to terminal care, nurses answered that they felt not always satisfied with present state (35.1%). Nurses' dissatisfaction was particularly in medical system (20.3%). As for night duty of nurse, care workers answered that nurses should work at night according to situation, but physicians and nurses themselves answered most that nurses might stand by at home. Nurses and care workers alike pointed out the necessity of increasing the number of nurses by 1-3 persons to secure the sufficient number of nurses. As the role of nurse in terminal care, physicians mentioned "observation and comprehension of condition" (15.8%), while nurses and care workers mentioned "contact and coordination with physician" (15.3% and 15.6%). Less
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