2023 Fiscal Year Final Research Report

Development of community-based educational program for multidisciplinary professionals to support ACP decisions

Research Project

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Project/Area Number	19K10531
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 58010:Medical management and medical sociology-related
Research Institution	Hamamatsu University School of Medicine
Principal Investigator	Inoue Machiko 浜松医科大学, 医学部, 特任教授 (80609090)
Co-Investigator(Kenkyū-buntansha)	金子惇横浜市立大学, データサイエンス研究科, 准教授 (80825076) 松井智子浜松医科大学, 医学部, 特任講師 (40886686) 樋口智也浜松医科大学, 医学部, 特任助教 (50888691)
Project Period (FY)	2019-04-01 – 2024-03-31
Keywords	アドバンス・ケア・プランニング / 地域医療・介護 / コミュニケーションスキル / アクションリサーチ
Outline of Final Research Achievements	The needs and issues for ACP practice among community-based medical and nursing care professionals in Hamamatsu City were explored, and three issues were identified: (1) raising awareness among community residents, (2) the need for communication skills training and tools for ACP, and (3) collaboration with medical staff in acute care hospitals. Efforts have been made to address each of these issues. For community-based medical and nursing staff, ACP leadership training and training for ACP communication with patients with dementia were conducted. For medical staff in acute care hospitals, an ACP guidebook 2 for use in ACP with patients with a prognosis of 1 year or less to live was developed, and mock interviews were conducted to obtain feedback on its practical application. For the general population, content evaluation and feedback for improvement were collected for interviews using the ACP guidebook and reflected in revisions.
Free Research Field	プライマリ・ケア
Academic Significance and Societal Importance of the Research Achievements	学術的意義としては、地域包括ケアシステムにおいてACPに基づく意思決定支援を推進するため、地域医療・介護多職種、急性期医療者、地域住民のそれぞれの視点からACP実践の課題を多角的に検討し改善に取り組んだ実践研究である点である。それぞれの立場にアプローチすることで、研修やACPツールの改善に活かすことができ、地域の実情に根ざしたモデル整備の基盤とした。社会的意義としては、超高齢社会において地域医療・介護に携わる多職種が、患者の人生の最終段階の医療・ケア・過ごし方についての希望や選好を話し合うためのスキルやツールを整備することで、患者の意思が尊重された医療・ケアの実現に寄与しうる点である。