Development of a Quality Scale for the Symptom Management of End-of-Life Dementia

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K20814
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Gerontological nursing
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: Yumoto Yoshie 東京医科歯科大学, 大学院保健衛生学研究科, 助教 (00755184)
• Research Collaborator: OGATA yasuko
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 認知症 / 終末期 / 症状マネジメント / 質指標

Outline of Final Research Achievements

This study aims to establish baseline knowledge for the development of a quality scale for the symptom management of end-of-life dementia. The knowledge baseline was established through the following means: a literature review, an observational study of palliative care for dementia patients in UK, and a qualitative study comprising semi-structured interviews of nurses and care workers experienced in providing care for end-stage dementia patients. The resulting data was synthesized and selected findings were published in an international journal.
A qualitative study was chosen for this project because end-stage dementia care in Japan is believed to be intimately connected to cultural context, a configuration that necessitated the creation of items to account for this cultural context in the scale. Findings from this study indicated that it would be appropriate to include additional symptoms in the scale to improve the management of end-of-life situations in Japan.

Free Research Field

高齢者看護

Academic Significance and Societal Importance of the Research Achievements

認知症終末期における症状マネジメントは、国内ではその内容を系統的に示すものはなく、各施設においてケア提供者の経験から良いとされるケアが行われてきた。
海外で開発された症状マネジメントの指標では、認知症患者本人の身体的症状が主に示されてきた。本研究では、「口腔の乾燥」「掻痒感」「孤独感」「家族の不安」等の新たな項目案が加わる可能性があり、家族が含まれる点で日本の文化を捉えているという特徴がある。今後国内において、項目の信頼性・妥当性の確認が必要であるが、本研究で抽出された項目は人が安寧な最期を迎える上で重要な項目となりうるため、終末期ケアの質に影響するような新たなケアの視点を齎す可能性がある。