2023 Fiscal Year Final Research Report

A Study on Creation of Support Programs Focusing on Hearing Loss of Elderly People with Dementia in Long-Term Care Insurance Facilities

Research Project

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Project/Area Number	21K11087
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 58080:Gerontological nursing and community health nursing-related
Research Institution	Ishikawa Prefectural Nursing University
Principal Investigator	Kawashima Kazuyo 石川県立看護大学, 看護学部, 教授 (40157855)
Co-Investigator(Kenkyū-buntansha)	渡辺達也石川県立看護大学, 看護学部, 助教 (40780276) 額奈々石川県立看護大学, 看護学部, 助教 (50889087) 中道淳子石川県立看護大学, 看護学部, 准教授 (70324085)
Project Period (FY)	2021-04-01 – 2024-03-31
Keywords	難聴 / 認知症 / 高齢者 / 看護師 / 介護保険施設 / 訪問看護ステーション / 病院
Outline of Final Research Achievements	Among nurses working at hospitals and home nursing stations in the Hokuriku region, 60-70% of the nurses reported frequent contact with elderly persons with hearing loss, and 90% of them felt difficulties in dealing with them. The most common situations in which nurses felt difficulties were "when explaining about treatment" and "when supporting decision-making. On the other hand, about 30% of the nurses "consider hearing loss when planning care. There was a significant relationship between the presence or absence of "planning care with consideration of hearing loss" and the experience of "learning about hearing loss in lectures when I was a student," "learning about hearing loss in training for new recruits," and "learning about hearing loss in workshops at my facility.In addition, more than 50-70% of the nurses had experience in communicating with an elderly person with dementia who had difficulty communicating without suspecting hearing loss.
Free Research Field	老年看護学分野
Academic Significance and Societal Importance of the Research Achievements	病院や訪問看護ステーションで勤務する看護師は、難聴を有する高齢者と接する頻度は高いが、難聴を考慮したケアプランの立案は3割にとどまっていた。これは、説明の理解ができないまま療養生活をおくっている患者が少なくないことを示唆している。また、認知症高齢者に対応するときに難聴を疑わず、意思疎通困難な人と判断した経験を持つ看護師が5～7割に上り、当事者の意思を尊重した「治療やケアに関する意思決定支援等」の前提が整わず、意思疎通困難者として本人が望まない治療やケアの選択を余儀なくされている可能性が明らかとなった。認知症高齢者がより多く暮らす介護保険施設にも難聴の程度の把握や支援の必要性が示唆された。