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A Study on Physician-Patient-Family Communication to Enable End-of-Life Care in Home medical Care

Research Project

Project/Area Number 18K07475
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 52010:General internal medicine-related
Research InstitutionTokyo Medical and Dental University (2023)
Saitama Medical University (2019-2022)
Kitasato University (2018)

Principal Investigator

Kimura Takuma  東京医科歯科大学, 大学院医歯学総合研究科, ジョイントリサーチ講座教授 (50722154)

Co-Investigator(Kenkyū-buntansha) 野村 恭子  秋田大学, 医学系研究科, 教授 (40365987)
石川 ひろの  帝京大学, 公私立大学の部局等, 教授 (40384846)
千葉 宏毅  北里大学, 医学部, 講師 (90713587)
Project Period (FY) 2018-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2020: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Keywords在宅医療 / コミュニケーション / 訪問診療 / 医療コミュニケーション / RIAS / 看取り / 医師患者関係 / 家族
Outline of Final Research Achievements

The purpose of this study was to clarify the content of communication between patients, companions, physicians, and non-physician professions (nurses, care managers, etc.) in home medical care, and to identify desirable communication to realize policies (including end-of-life care at home) in accordance with the patient's wishes. Conversations during actual home medical cares (55 cases at 9 facilities nationwide) were recorded with an IC recorder, and the data were analyzed.
The analysis revealed that the role of the second companion’s function in communication in home medical care was similar to that of the first companion, such as providing information and playing a facilitative role to the patient, and that topics related to absent professionals and absent family members were important during the treatment and utilized in multidisciplinary collaboration.

Academic Significance and Societal Importance of the Research Achievements

学術的意義として、医療における会話の内容を分析する国際的な標準的ツールであるThe Roter Interaction Analysis System(RIAS) で分類した点がある。また、今回、在宅医療に適するコード(分類法)を開発した。
社会的意義として、医師は在宅医療において、一人目の付き添い者に加えて、二人目の付き添い者にも注意を払うべきであることが明らかになった。また、在宅医療における多職種連携を推進する上で、医師は、患者、付き添い者、様々な専門職からの診療に不在の専門職からの情報に留意すべきであることが明らかになった。

Report

(7 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (7 results)

All 2024 2023 2022 2021

All Journal Article (6 results) (of which Peer Reviewed: 3 results) Book (1 results)

  • [Journal Article] Communication between physicians, patients, their companions and other healthcare professionals in home medical care in Japan2024

    • Author(s)
      Kimura Takuma、Chiba Hiroki、Nomura Kyoko、Mizukami Junya、Saka Shohei、Kakei Kotaro、Ishikawa Junya、Yamadera Shinichi、Sakato Keiichiro、Fujitani Naoaki、Takagi Hiroshi、Ishikawa Hirono
    • Journal Title

      Patient Education and Counseling

      Volume: 123 Pages: 108239-108239

    • DOI

      10.1016/j.pec.2024.108239

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 特集 症例から読み解く-高齢者診療ステップアップ "こころ"と"身体"の臨床 高齢者における医療面接2023

    • Author(s)
      木村 琢磨
    • Journal Title

      medicina

      Volume: 60 Issue: 9 Pages: 1380-1385

    • DOI

      10.11477/mf.1402229072

    • ISSN
      0025-7699, 1882-1189
    • Year and Date
      2023-08-10
    • Related Report
      2023 Annual Research Report
  • [Journal Article] Perspective of Home Medical Care in the Post-Corona Era2023

    • Author(s)
      Kimura Takuma
    • Journal Title

      Nihon Naika Gakkai Zasshi

      Volume: 112 Issue: 5 Pages: 851-856

    • DOI

      10.2169/naika.112.851

    • ISSN
      0021-5384, 1883-2083
    • Year and Date
      2023-05-10
    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 我が国における在宅医療の質評価2023

    • Author(s)
      木村 琢磨、松村 真司、川越 正平
    • Journal Title

      Journal of Japanese Association for Home Care Medicine

      Volume: 4 Issue: 4 Pages: 16-23

    • DOI

      10.34458/jahcm.4.4_16

    • ISSN
      2435-4007
    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 性差を考慮した医療面接、医師の性別からの論考2021

    • Author(s)
      木村琢磨
    • Journal Title

      内科

      Volume: 127 Pages: 1045-1050

    • Related Report
      2021 Research-status Report
  • [Journal Article] 性差を考慮した医療面接、患者の性別からの論考2021

    • Author(s)
      木村琢磨
    • Journal Title

      内科

      Volume: 127 Pages: 1039-1043

    • Related Report
      2021 Research-status Report
  • [Book] 高齢者診療の極意2022

    • Author(s)
      木村琢磨
    • Total Pages
      284
    • Publisher
      医学書院
    • ISBN
      9784260050272
    • Related Report
      2022 Research-status Report

URL: 

Published: 2018-04-23   Modified: 2025-01-30  

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