2019 Fiscal Year Final Research Report
Difficulties in End-of-Life Care at Home in Its Initial Stage and Their Causal Analyses
| Project/Area Number |
17K04234
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Social welfare and social work studies
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| Research Institution | Japan Health Care College |
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Principal Investigator |
Hayashi Mieko 日本医療大学, 保健医療学部, 教授 (40295928)
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| Co-Investigator(Kenkyū-buntansha) |
永田 志津子 札幌大谷大学, 社会学部, 教授 (60198330)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Keywords | 在宅看取り / 家族介護者 / 環境設定 / 困難性 / 看取りねっと / 地域完結型社会 / 死の受容 / 死のドゥーラ |
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| Outline of Final Research Achievements |
The purpose of this study is to reveal the causes for difficulties in the initial environmental arrangement of end-of-life care at home. Medical and nursing-care specialists have a strong recognition that family caregivers are mainly responsible for end-of-life care at home and accordingly they are expected to complement family caregivers. Additionally, while the success of end-of-life care at home depends on appropriate connections with the specialists, patients and their family members were not given the room to choose care services for supporting home nursing or the providers of such services. The text analyses of interviews found that the difficulties in the initial environmental arrangement were heavily influenced by the distrust and dissatisfaction with a hospital and its doctors caused through their treatment methods and handlings at the time of a patient’s hospital visits and admission, revealing that there was a lack of supports for the acceptance of death.
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| Free Research Field |
社会福祉 文化人類学 医学社会学
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| Academic Significance and Societal Importance of the Research Achievements |
住み慣れた我が家を死亡場所として希望する者の率は高いが、現実の死亡場所の多くは病院である。2012年からの政策的な在宅死への誘導は、この希望と現実の乖離を解決する方策と思われたが、在宅での看取り率はその後もほぼ横ばいである。在宅看取りの実施や継続、その成否に深く影響すると思われることの一つがその初期段階での環境整備の困難性である。医療・介護の専門家や当事者である家族介護者の多様な個別具体的な語りから、その困難性の原因を分析した本研究の成果は、家族介護者への初期支援の在り方を見直す機会を提供するものであり、他者の死から学ぶことで、遺された者がより良く生きる情報源となる社会的意義を有している。
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