| Project/Area Number |
16K15972
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| Research Category |
Grant-in-Aid for Challenging Exploratory Research
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| Allocation Type | Multi-year Fund |
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| Research Field |
Gerontological nursing
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| Research Institution | Tokyo Health Care University |
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Principal Investigator |
Tanimoto Mariko 東京医療保健大学, 医療保健学部, 教授 (70279834)
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| Co-Investigator(Kenkyū-buntansha) |
西川 満則 国立研究開発法人国立長寿医療研究センター, 病院, 医師 (70557214)
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| Project Period (FY) |
2016-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2016: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
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| Keywords | アドバンスケアプランニング / 地域医療 / 高齢患者 / 家族 / ACP / 意向把握 / 意向共有 / 多職種 / 継続医療 / 実践モデル / アドバンスケアプランニング゛ / エンドオブライフケア / 高齢者 |
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| Outline of Final Research Achievements |
According to the Japanese ACP research review, we have confirmed that our primary task is to take into account the Japanese healthcare systems and the Japanese culture and establish the ACP intervention based on those. We have conducted an interview on the 22 interdisciplinary healthcare professionals from a pioneering facility developed the home healthcare system that integrates ACP for dying elderly patients. 6main practical contents and 20items were extracted from the interview data. Besides, we have found that improving the quality of everyday care and the effective performance from each professional possibly contribute to the improvement of the quality of the overall health care through the ACP process. However, further research is needed to determine how the decision-making support is done in the process of the deteriorating mental capacity and physical status, as well as the elderly and family member's experiences through the ACP.
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| Academic Significance and Societal Importance of the Research Achievements |
日本において終末期医療の自己決定権を保証する法律はない。本人の意向を中心とする話し合いのプロセスを重視する「人生の最終段階における医療・ケアの決定プロセスに関するガイドライン」で推進し、これを拠り所としてそれぞれの現場で試行錯誤しながら取り組んでいる現状がある。本研究の成果は、地域ケアシステムのケアチームで取り組むACPの実践内容である。チーム全体で高齢患者のACPに取り組むシステムづくりと、チームメンバー個々が日々の実践で取り組む課題を見極めるうえで手がかりとなる具体的実践を言語化した点で意義がある。
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