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Construction of a nursing system leading to improvement in QOL of laryngectomized patients: Longitudinal intervention by RCT

Research Project

Project/Area Number 19H03937
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Review Section Basic Section 58060:Clinical nursing-related
Research InstitutionNara Medical University

Principal Investigator

KOTAKE KUMIKO  奈良県立医科大学, 医学部, 教授 (90320639)

Co-Investigator(Kenkyū-buntansha) 鈴鴨 よしみ  東北大学, 医学系研究科, 准教授 (60362472)
岩永 和代  福岡大学, 医学部, 准教授 (40461537)
甲斐 一郎  東京大学, 大学院医学系研究科(医学部), 名誉教授 (30126023)
羽場 香織  奈良県立医科大学, 医学部, 助教 (90419721)
栗田 麻美  奈良県立医科大学, 医学部, 講師 (00574922)
高橋 綾  埼玉県立大学, 保健医療福祉学部, 准教授 (70331345)
石橋 曜子  福岡国際医療福祉大学, 看護学部, 講師 (70469386)
原 頼子  久留米大学, 医学部, 教授 (60289501)
新 裕紀子  久留米大学, 医学部, 助教 (10782055)
太田 一郎  近畿大学, 奈良病院, 講師 (00326323)
上村 裕和  奈良県立医科大学, 医学部, 病院教授 (90285370)
Project Period (FY) 2019-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥17,160,000 (Direct Cost: ¥13,200,000、Indirect Cost: ¥3,960,000)
Fiscal Year 2022: ¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000)
Fiscal Year 2021: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
Fiscal Year 2020: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2019: ¥5,590,000 (Direct Cost: ¥4,300,000、Indirect Cost: ¥1,290,000)
Keywords喉頭全摘出者 / 喉頭・咽頭がん / 心理的適応 / QOL / 情報・心理的サポート / RCT / 看護介入 / 継続看護 / 縦断調査 / 術前 / 退院3ヶ月後 / 退院1年後 / 情報的・心理的サポート / 喉頭摘出者 / 術前から退院12ヶ月後 / 情報的心理的サポート / 嚥下困難 / 味覚・嗅覚障害 / ソーシャルサポート / 味覚嗅覚障害 / 看護体制
Outline of Research at the Start

咽喉頭がんによる喉頭全摘出者は, 術前からがんによる辛さがあり, 術後も失声障害や永久気管孔造設に伴う生活のしづらさが生じるため,QOLは退院1年後も術前と変わらず低いままである。特に, 退院3か月後のQOLは, 心身社会面の全てに下降傾向があり, 社会復帰後の適応の困難さが窺えた。QOL向上においてフォーマルな情報的・心理的サポートが有効だが、その体制は十分に整えられていない。そこで本研究は, 喉頭摘出者の暮らしを支える看護介入に関する訓練を受けた看護師を配置し, 術前から退院1年後までの看護介入の効果をRCTにて検証し, 退院後も安心して暮らせるようシームレスな看護体制の構築を目指す。

Outline of Final Research Achievements

【Purpose】The primary outcome was to determine whether informational/psychological nursing intervention could maintain and improve the psychological adjustment and quality of life of laryngectomized patients from preoperatively to 3 months after discharge without decreasing it, compared to information. The secondary outcome was to determine whether the nursing intervention could continue to improve psychological adjustment and quality of life up to one year after discharge, compared to the informational intervention.【Methods】The study design was a Randomized Controlled Trial intervention study using a guidebook and interviews based on the results of previous studies by the applicants, and a quantitative study.【Results】The results showed that nursing intervention maintained their psychological adjustment and quality of life from preoperatively to 3 months after discharge without declining, and were able to continue to improve until 1 year after discharge.

Academic Significance and Societal Importance of the Research Achievements

本研究結果は、世界初の結果である。RCTにより、ガイドブックのみ対照群とガイドブックと面接看護介入の比較結果、退院3ヶ月後にQOL下降せず、退院1年後も術前よりやや上回る傾向がみられた。術前から継続的に看護者が面接をしながら一緒に患者と伴走する継続看護の重要性を示唆する結果であった。術前からケアチーム体制を整えて継続看護をする必要があり、各病院の特徴に合わせてチーム地勢を整える研究が求められる。

Report

(5 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Annual Research Report
  • 2020 Annual Research Report
  • 2019 Annual Research Report
  • Research Products

    (20 results)

All 2022 2021 2020 2019

All Journal Article (4 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 3 results,  Open Access: 1 results) Presentation (14 results) (of which Int'l Joint Research: 13 results) Book (2 results)

  • [Journal Article] N:ナラティブとケア 質的研究のリアルーナラティブの境界を探る「喉頭摘出者の生活のプロセス:術前と退院3か月後」2022

    • Author(s)
      小竹久実子
    • Journal Title

      遠見書房

      Volume: 13 Pages: 89-96

    • Related Report
      2021 Annual Research Report
  • [Journal Article] Effects of occupational status on social adjustment after laryngectomy in patients with laryngeal and hypopharyngeal cancer2019

    • Author(s)
      Kotake K, Kai I, Iwanaga K, Suzukamo Y, Takahashi A.
    • Journal Title

      Eur Arch Otorhinolaryngol.

      Volume: 276 (5) Pages: 1439-1446

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] わが国の訪問看護に関わる臨床判断研究のシステマティックレビュー2019

    • Author(s)
      栗田 麻美, 小竹久実子
    • Journal Title

      日本在宅看護学会誌

      Volume: 7 (2) Pages: 62-72

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 看護師における特性的自己効力感尺度の方法因子を用いた因子構成の検討2019

    • Author(s)
      熊谷 たまき, 小竹 久実子, 藤村 一美
    • Journal Title

      大阪市立大学看護学雑誌

      Volume: 15 Pages: 1-7

    • NAID

      120006595788

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Presentation] The Study of Quality of Life Evaluation by using EORTC-QLQ-C30 and H&N35 for Head and Neck Cancer Patients who Received Chemoradiotherapy2022

    • Author(s)
      Iwanaga K, Arima H, Ishibashi Y, Maki K, Ura A, Kotake K, Haba K
    • Organizer
      International Conference on Cancer Nursing 2022
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Long-term time courseof quality of life evaluatedSF36v2 among head and neck cancer patients who received chemoradiotherapy2022

    • Author(s)
      Iwanaga K, Arima H, Ishibashi Y, Ura A, Kotake K, Haba K
    • Organizer
      25thEAFONS(East Asian Forum of Nursing Scholars Conference, 2022
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Changing Daily Life of Total Laryngectomized Patients Three Months After Hospital Discharge2022

    • Author(s)
      Kotake K, Kinoshita Y, Haba K, Kurita M, Iwanaga K, Kai I, Suzukamo Y, Ishibashi Y, Takahashi A, Hara Y, Arata Y, Ota I, Uemura H
    • Organizer
      33th Sigma Theta Tau International 33th Internatiol Nursing Research Congress
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Reasons for Participation, Discontinuation and Non-participation in Self-help Groups among Laryngectomized Patients in Japan2022

    • Author(s)
      Haba K, Kotake K, Kurita M, Iwanaga K, Kai I, Suzukamo Y, Takahashi A, Ishibashi Y, Hara Y, Arata Y, Ota I, Uemura H, Taniguchi H.
    • Organizer
      Sigma Theta Tau International 33th Internatiol Nursing Research Congress
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research
  • [Presentation] The Preoperative Life Process of Pharyngeal and Laryngeal Cancer Patients Undergoing Total Laryngectomy2021

    • Author(s)
      Kotake K, Iwanaga K, Haba K, KuritaM, Ota I, SuzukamoY, Kai I et al.
    • Organizer
      32th International Nursing Research Congress, 20-23 JUL. at on line
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Nursing perspectives that Serve as the basis for Clinical Judgements of Visiting Nurse Focus on Nursing Care for Cancer Patients Receiving End-of-Life Care at Home2021

    • Author(s)
      Kurita M, Kotake K
    • Organizer
      32th International Nursing Research Congress, 20-23 JUL. at on line
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Process of Becoming “Aware” in Visiting Nurses through Nursing Practice2021

    • Author(s)
      Yano M, Kotake K
    • Organizer
      32th International Nursing Research Congress, 20-23 JUL. at on line
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research
  • [Presentation] The Study of Quality of Life Evaluation by using EORTC QLQ C-30 for Head and Neck Cancer Patients who Received Chemoradiation Therapy2020

    • Author(s)
      Iwanaga K, Ishibashi Y, Ura A, Miyabayashi I, Kotake K, Haba K
    • Organizer
      23th East Asian Forum of Nursing Scholars
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] The Study of Quality of Life Evaluation by using SF36 for Head and Neck Cancer Patients who Received Chemoradiation Therapy2020

    • Author(s)
      Iwanaga K, Ishibashi Y, Ura A, Miyabayashi I, Kotake K, Haba K
    • Organizer
      The 6th International Nursing Research Conference of Word Academy of Nursing Science
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] The Examination of Reliability and Validity of a Japanese Versionof the Oldenburg Burnout Inventory2020

    • Author(s)
      Kumagai T, Kotake K, Fujimura K, Sannomiya Y
    • Organizer
      The 6th International Nursing Research Conference of Word Academy of Nursing Science
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] The Effect of Nurses' Sense of Mastery on Their Burnout and Mental Health2020

    • Author(s)
      Kumagai T, Kotake K, Fujimura K, Sannomiya Y
    • Organizer
      The 6th International Nursing Research Conference of Word Academy of Nursing Science
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 入院期間中に実践される喉頭摘出者の社会的適応を促進する看護援助2019

    • Author(s)
      高橋綾, 小竹久実子, 甲斐一郎, 鈴鴨よしみ, 岩永和代 他
    • Organizer
      第39回日本看護科学学会学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] The Effect of Continuous Nursing Intervention by a Randomized Controlled Trial on Laryngectomized Patients' QOL2019

    • Author(s)
      Kumiko Kotake, KazuyoIwanaga, Yoshimi Suzukamo, Ichiro Kai , AyaTakahashi , Kaori Haba, Yoko Ishibashi, MamiMiyazono, MamiKurita, Ichiro Ota, HirokazuUemura, Tadasi Kitahara, Hiromi Taniguchi, Sakae Matuoka, Naomi Mine
    • Organizer
      30th International Nursing Research Congress
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Participation of Laryngectomized Patients in Self-help Groups and Their Motivations for Status Changes2019

    • Author(s)
      Kaori Haba , Kumiko Kotake , Kazuyo Iwanaga , Ichiro Kai , Yoshimi Suzukamo , Aya Takahashi , Yoko Ishibashi , Mami Miyazono , Mami Kurita ,Ichiro Ota , Hirokazu Uemura , Tadashi Kitahara , Hiromi Taniguchi , Sakae Matsuoka , Naomi Mine
    • Organizer
      30th International Nursing Research Congress
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Book] ナラティブとケア 質的研究のリアルーナラティブの境界を探る2022

    • Author(s)
      木下康仁編 小竹久実子、野口裕二、志村健一、小倉康嗣、宮下道夫、佐川佳南枝、稲毛和子、五味麻美、飯島聖香・片岡弥恵子
    • Total Pages
      105
    • Publisher
      遠見書房
    • Related Report
      2022 Annual Research Report
  • [Book] 応用心理学ハンドブック2022

    • Author(s)
      日本応用心理学会、応用心理学ハンドブック編集委員会、藤田 主一、古屋 健、角山 剛、谷口 泰富、深澤 伸幸
    • Total Pages
      858
    • Publisher
      福村出版
    • ISBN
      9784571200878
    • Related Report
      2022 Annual Research Report

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Published: 2019-04-18   Modified: 2024-01-30  

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