Decision-making process of medical care for people who have no relatives and have difficulty in decision-making

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K02056
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 08020:Social welfare-related
• Research Institution: Health Science University
• Principal Investigator: Yamazaki Sayaka 健康科学大学, 看護学部, 助教 (60784585)
• Co-Investigator(Kenkyū-buntansha): 山縣 然太朗 山梨大学, 大学院総合研究部, 教授 (10210337)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 身寄りがない人 / 意思決定が困難な人 / 認知症 / 意思決定支援 / 権利擁護 / 医療の決定プロセス

Outline of Final Research Achievements

We reviewed previous domestic and foreign studies on the decision-making process of medical care for people without family and have difficulty making decisions. Medical care for people without family and have difficulty in making decisions involved issues such as delays in treatment and inability to reflect the patient's wishes. Questionnaire and interview survey data from hospitals nationwide were analyzed. When people without famil are hospitalized, medical decision-making becomes difficult. In addition, a high percentage of the medical decisions were made by the medical team as the medical decision-making process. Based on this analysis, we cooperated in the development of collection of examples on supported decision-making for people without family and for people who have difficulty making decisions regarding medical care. The collection of examples was disseminated through workshops and seminars.

Free Research Field

老年看護学

Academic Significance and Societal Importance of the Research Achievements

今まで明らかになっていなかった日本の病院における身寄りがない患者の実態や課題を明らかにした。「身寄りがない人の入院及び医療に係る意思決定が困難な人への支援に関するガイドラインに基づく事例集」は、身寄りがない人の医療の決定についての標準的な考え方を提示した。今後、単身世帯の増加、認知症高齢者の増加がすることが予測されるが、標準的な医療の決定プロセスを定めることで、対応の質の向上につながる。また、患者とその家族が安心して医療・ケアチームに医療の決定を委ねることが可能になると考える。