Development of a new patient education model through the use of concept of Concordance for nurses caring for pre-dialysis patients with chronic kidney disease(CKD)

Research Project

Project/Area Number	17H07208
Research Category	Grant-in-Aid for Research Activity Start-up
Allocation Type	Single-year Grants
Research Field	Clinical nursing
Research Institution	Kanazawa Medical University
Principal Investigator	ARAI Satomi 金沢医科大学, 看護学部, 助教 (90802413)
Project Period (FY)	2017-08-25 – 2019-03-31
Project Status	Completed (Fiscal Year 2018)
Budget Amount *help	¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000) Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords	コンコーダンス / 療養指導 / 慢性腎不全 / コミュニケーション / 保存期慢性腎臓病
Outline of Final Research Achievements	The purpose of this study was to develop a new, personalized patient education model for use by nurses that would promote health behavior change in pre-dialysis patients with CKD by documenting the recovery experiences of repeatedly hospitalized patients using concept of concordance. I first interviewed 11 pre-dialysis inpatients with CKD and identified the following categories: experiences of living with CKD and utilizing the available support; experiences of not being able to accept asymptomatic CKD and continuing to struggle. I then performed action research on the renal ward nurses. I reviewed the patient experiences I collected and discussed personalized patient education with the nurses. They reported that by learning about the patient experiences, 1) they understood the importance of having a broad view for the current patient education situation; 2) they were able to reflect on their own nursing experiences; and 3) they realized the need for patient-centered perspectives.
Academic Significance and Societal Importance of the Research Achievements	本研究は、これまで着目されてこなかったCKD患者の療養体験に焦点を当てていること、腎臓内科病棟看護師と協働しコンコーダンス概念を活用した新たな療養指導モデルを考案することに学術的な独創性がある。新しい療養指導モデルによって、CKD患者が行動変容し生活習慣の改善が図られると、年間4万人といわれている新規透析導入患者の発生を回避できる。これは患者の合併症の予防やQOLの向上に寄与し、それに伴い医療費が削減されることから医療経済的にもよい影響が期待される。また患者自身が主体的に療養生活を編み直していくことが必要なあらゆる疾患の療養指導のあり方への示唆が得られると考えられる。