A study on chronic disease management program for users of welfare facilities for persons with disabilities

Research Project

Project/Area Number	17K19836
Research Category	Grant-in-Aid for Challenging Research (Exploratory)
Allocation Type	Multi-year Fund
Research Field	Society medicine, Nursing, and related fields
Research Institution	Hokkaido University (2020-2021) Hokkaido University of Science (2017-2019)
Principal Investigator	Nozomi Takayama 北海道大学, 保健科学研究院, 客員研究員 (50451399)
Co-Investigator(Kenkyū-buntansha)	笹木弘美北海道科学大学, 保健医療学部, 教授 (20275499) 松原三智子北海道科学大学, 保健医療学部, 教授 (20304115)
Project Period (FY)	2017-06-30 – 2022-03-31
Project Status	Completed (Fiscal Year 2021)
Budget Amount *help	¥5,720,000 (Direct Cost: ¥4,400,000、Indirect Cost: ¥1,320,000) Fiscal Year 2019: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000) Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000) Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Keywords	疾病管理 / 慢性看護 / 地域連携
Outline of Final Research Achievements	A 6-month chronic disease management program was conducted for the high-risk group and the medium-risk group, and 9 subjects who were able to participate until the end were analyzed. The subjects were 9 (5 males and 4 females) with an average age of 50.2 ± 16.0 years. Based on the start of the intervention, body weight, obesity, abdominal circumference, and blood pressure were measured monthly, and blood glucose level and blood vessel age were measured at the start, middle, and after the intervention. The 30s and 40s with intellectual disabilities and mental illnesses were a group that did not have a diagnosis of chronic illness but required diet and exercise therapy. People in their 50s and 70s understood the need for diet and exercise therapy to avoid aggravation of chronic illness, but it was difficult to put it into practice. As a countermeasure, it was effective to focus on high-priority goals and show concrete actions.
Academic Significance and Societal Importance of the Research Achievements	障がい者の健康ニーズに関する研究では，肥満や引きこもりが多いこと，症例ごとに包括的地域ケアの必要性が提示されている．障がい者の福祉施設には，医療者の配置基準がなく，障がい者の健康ニーズを捉え，効果的な介入をする医療者がいない．障がい者においても慢性疾患を中心とした疾病構造と共通した課題があるにも関わらず，未解決の課題である．本研究は，障がい者の慢性疾患管理に着目している．高リスク層に対する徹底した慢性疾病管理を実施することで，疾病の予防や重症化を防ぐことができる．また，家族や福祉施設，医療機関を活用した地域連携モデルの構築を目指す必要がある．