2022 Fiscal Year Final Research Report

Determination of evidence on observational methods leading to early detection of pupillary abnormality

Research Project

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Project/Area Number	20K10624
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 58050:Fundamental of nursing-related
Research Institution	Kansai University of Social Welfare
Principal Investigator	KAWANISHI Chiemi 関西福祉大学, 看護学部, 教授 (40161335)
Co-Investigator(Kenkyū-buntansha)	飯田直美関西福祉大学, 看護学部, 助教 (40764890) 掛田崇寛関西福祉大学, 看護学部, 教授 (60403664) 福岡泰子関西福祉大学, 看護学部, 准教授 (60410205) 西村夏代関西福祉大学, 看護学部, 准教授 (60553980) 永田文子淑徳大学, 看護栄養学部, 准教授 (30315858)
Project Period (FY)	2020-04-01 – 2023-03-31
Keywords	瞳孔測定 / 定量的瞳孔計 / 重症患者 / 自信
Outline of Final Research Achievements	The purpose of this study was to ascertain evidence for methods of pupil diameter measurement in the early detection of abnormalities among critically ill patients in Japan. Studies elsewhere have reported minimal scope for measurement error when scientific instruments are used, but errors have been found in manual measurements. No Japanese studies were identified in which nurses used instruments to take measurements. Accordingly, an internet survey (N=c. 6,000) was undertaken to clarify nurses’ experience of, and confidence in, taking pupil measurements. The findings showed an average age of 47.4 years, and an average experience of 21.7 years. Just over half of the nurses had taken pupil measurements manually. Among the subjects of the survey, 26 had experience of instrumental measurement, and their average level of confidence was 3 points on a 6-point scale. From this, it is clear that nurses must be made aware of equipment that can be used for pupil diameter measurement.
Free Research Field	看護技術
Academic Significance and Societal Importance of the Research Achievements	海外文献では、瞳孔径測定に器械を使用し、測定者間の誤差が少なく、手動による瞳孔径測定は不正確であると報告されていた。日本においてより正確性が確実である器械測定を実施している施設は少なく、看護師は手動測定を実施していた。看護師は瞳孔測定の値にあまり自信が持てない状況であるため、器械を用いて根拠となる値がわかれば看護師の測定技術向上や自信にも繋がると考えられる。どんな看護師でも、自信をもって正確に瞳孔測定できれば患者の異常の早期発見に寄与する。また予後予測も可能となるため患者家族の助けにもなると考えられる。今回コロナ禍で実際の重症患者での瞳孔測定が実施できなかったが今後継続予定である。