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Changes of body movements on the bed and nurses' prediction of impending death in end-of-life cancer patients: a prospective observational study

Research Project

Project/Area Number 21K09007
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 55050:Anesthesiology-related
Research InstitutionChiba Cancer Center (Research Institute)

Principal Investigator

Suganuma Dai  千葉県がんセンター(研究所), 緩和医療科, 医長 (70898402)

Co-Investigator(Kenkyū-buntansha) 田口 奈津子  千葉大学, 大学院医学研究院, 准教授 (80282474)
Project Period (FY) 2021-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2023: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2022: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000)
Fiscal Year 2021: ¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000)
Keywords緩和医療 / バイタルパラメータ / 癌終末期 / 看護行為 / 生体情報 / 病状変化 / 担癌患者終末期
Outline of Research at the Start

癌終末期の患者や家族にとって、よい終末期を迎えることは重要である。緩和医療に専従する看護師は、死が72時間以内と差し迫っていることを約80%予測可能とされる。しかしながら、がん終末期の患者に不必要なモニター装着は実施困難なため、これを科学的に支持するエビデンスはない。本研究は非接触非拘束型モニターを用いることで、癌終末期の日常診療と療養に影響を与えずにバイタルパラメータを取得し、それらのパラメータと緩和医療に専従する看護師の72時間に切迫した死に対する予覚との関係を明らかにすることで、緩和医療非従事者でも臨死期の予兆を得るバイタルサインを明らかにする研究である。

Outline of Final Research Achievements

This study investigated the association between nurses' actions and vital signs in terminally ill cancer patients. Nurses predict death within 72 hours with high accuracy, but objective data is lacking. We reviewed nursing records for actions and used a non-contact and non-restricted vital parameter recording system (bed sensor system) to monitor patients without disrupting care. This study included 40 patients. The study found that nurse’s action of radial artery pulse check and oral medications discontinuation were most often recorded within 3-6 days of death. Additionally, patients spent more time in bed during daytime, had less stable breathing patterns, and showed lower nighttime activity when nurses checked pulses compared to those of three days prior.
These findings could help standardize palliative care, develop models to predict health changes, and support medical professionals' decisions. This research contributes to improving end-of-life care for terminally ill patients.

Academic Significance and Societal Importance of the Research Achievements

本研究で明らかになった看護行動発生とバイタルパラメータの関係性は、 緩和ケアの標準化や病状変化を予測する臨床予測モデルの構築や医療者の判断支援への情報提供へと繋がる可能性があり、緩和医療の標準化に寄与しえる研究成果である。

Report

(4 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (1 results)

All 2024

All Presentation (1 results)

  • [Presentation] 緩和病棟入院患者の床上活動の大きさの変化と病状変化に対する看護師の臨床判断の関 係についての観察研究2024

    • Author(s)
      菅沼大
    • Organizer
      第 1506回千葉医学会例会,第 57回麻酔科例会,第 85回千葉麻酔懇話会
    • Related Report
      2023 Annual Research Report

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Published: 2021-04-28   Modified: 2025-01-30  

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