Construction of an early urination independence support system based on long-term outcomes and cost-effectiveness of elderly patients

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K12192
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Gerontological nursing
• Research Institution: Kanazawa University
• Principal Investigator: Shogenji Miho 金沢大学, 保健学系, 助教 (80345636)
• Co-Investigator(Kenkyū-buntansha): 吉田 美香子 東京大学, 大学院医学系研究科(医学部), 特任講師 (40382957) ; 平松 知子 金沢医科大学, 看護学部, 教授 (70228815)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 排尿自立 / 急性期 / 回復期リハビリテーション病棟 / 脳卒中患者 / 尿路感染症

Outline of Final Research Achievements

Objective: This quasi-experimental study evaluated the effectiveness of a continuous continence program on continence self-management. Method: Participants were stroke patients with indwelling catheters in an acute hospital (intervention group: n=70, control group: n=60). Intervention group (IG) received continuous continence program between acute phase and rehabilitation phase. The control group (CG) received same continence care only in acute phase. Result: The incidence of UTIs in the IG was significantly lower than that in the CG (0% vs. 6.7%, p＝0.028). Proportion of patient who can void urine as same method as that before stroke was higher in the IG, comparing with the CG (85.7% vs. 72.9%, p＝0.070). UTI resulted in the much higher incidence of re-indwelling catheter and longer stay in the rehabilitation ward. Conclusion: This study demonstrated that continuous comprehensive continence care for the removal of indwelling catheters lowered the incidence of UTIs.

Free Research Field

老年看護学

Academic Significance and Societal Importance of the Research Achievements

本研究は、急性期病院で尿道カテーテル留置管理となった脳卒中患者に対して、急性期病院から回復期リハ病棟へ排尿行動の自立を目指した継続的排尿自立支援を行い、その有効性を示した。また、基礎疾患や尿道カテーテル留置管理に関わらず、残尿を認める高齢患者が存在することが入院時スクリーニングにより分かってきた。今後、本研究結果をもとに排尿自立支援が普及することにより、高齢患者の生活機能の維持・拡大、ひいては健康寿命の延長に貢献できると考えられる。