| Project/Area Number |
15KT0004
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Multi-year Fund |
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| Section | 特設分野 |
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| Research Field |
Neo-Gerontology
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| Research Institution | Keio University (2016-2019)
Hamamatsu University School of Medicine (2015) |
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Principal Investigator |
YAMAGISHI Akemi 慶應義塾大学, 医学部(信濃町), 講師(非常勤) (30433626)
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| Co-Investigator(Kenkyū-buntansha) |
森田 達也 聖隷クリストファー大学, 看護学研究科, 臨床教授 (70513000)
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| Project Period (FY) |
2015-07-10 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥17,940,000 (Direct Cost: ¥13,800,000、Indirect Cost: ¥4,140,000)
Fiscal Year 2018: ¥6,110,000 (Direct Cost: ¥4,700,000、Indirect Cost: ¥1,410,000)
Fiscal Year 2017: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2016: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2015: ¥6,110,000 (Direct Cost: ¥4,700,000、Indirect Cost: ¥1,410,000)
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| Keywords | advance care planning / 地域包括ケア / 在宅・救急医療の連携 / 医療・介護連携 / 高齢者救急 / 高齢者救急搬送 / アドバンスケアプラニング / 救急医療と在宅医療の連携 / 意思決定支援 / 多職種協働 / 地域包括ケアシステム / 救急医療 / 在宅医療・看護 / 在宅医療 / l救急医療 / 終末期医療 / 意思決定 |
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| Outline of Final Research Achievements |
The intervention program(consisting of four pillars: 1) operation of emergency contact sheets, 2) training for care support specialists, 3) operation of local rules for transporting elderly people, and 4) public awareness) was evaluated using the Cluster-RCT design. As a result, in the intervention group, there were significantly many people who expressed their hopes for spending the end their lives, and the rate that the hopes and actual conditions were consistent was high, and the number of undesired emergency transportation at the final stage of their life was reduced.
In the process evaluation, what was suggested as having contributed to improving outcomes was that the care support specialists improved target persons' ACP readiness by providing ACP knowledge and confirming companion-type support based on the relationship of trust, and the care support specialists were able to properly connect with medical staff Depending on the hope and the content of discussion.
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| Academic Significance and Societal Importance of the Research Achievements |
ご本人の望む過ごし方を含む人生会議の結果を介護・医療の専門職が共有することで、人生の最終段階のアウトカム向上に貢献しうることが示唆された。
研究事業のプロセスで得られた知見に関しては、2017年度～2019年度の厚生労働省医政局「在宅医療・救急医療連携にかかる調査・セミナー事業」や「基礎自治体が取り組む在宅医療・救急医療連携推進のための手引き」においても、多くの知見が活用された。さらに、基礎自治体（70件）、大学等教育（45件）、医療機関（69件）、職能団体（66件）、その他（35件）と、多くの自治体および団体で当該研究に関する講演会が企画された。
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