阿仁地域における住民の死生観と在宅終末期医療に関する意識（第2回調査）

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  • アニ チイキ ニ オケル ジュウミン ノ シセイカン ト ザイタク シュウマツキ イリョウ ニ カンスル イシキ(ダイ2カイ チョウサ)
  • Views on life and death and the awareness of terminal home care among residents of the Ani region: the second survery

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過疎が進むルーラル(農村〉の住民の死生観と終末期医療に関する意識を横断的経時的に明らかにする調査として，高齢化率が49.5%である秋田県阿仁地域の住民784名に質問紙調査を行い， 234名の回答から以下の結果と考察を得た.調査地域の住民の「死」に対する印象は， 「寂しい」「別離」「自然」であり，理想的な「死」は， 「周囲に迷惑をかけない」死であった.終末期の療養場所として「自宅」を希望する者は41.9%であり，自宅死を可能とする条件は， 「家族の理解と協力」「かかりつけ医の支援」「訪問看護師の支援」であり，自宅に訪問し自立生活を支援する看護職による訪問看護が在宅医療システムの中心を担い得ることを示唆している.過疎が進む地域における今後の地域包括ケアシステムの整備にあたっては，サービスの受け手である地域住民のニーズと広いエリアで地域を捉えた際に現存する社会資源との整合性や利便性を検証していくことが課題であると考える.

A questionnaire survey was conducted in the Ani region of Akita, Japan, as part of an ongoing crosssectional study to investigate the views on "life and death" and "terminal care" among residents living in rural farming communities that are experiencing depopulation. The Ani region in Akita has a populationaging rate of 49.5%. The questionnaires were given to 784 residents. The following results and discussion were based on the responses from 234 residents. The residents who participated in the survey associated the impressions of "death" with "loneliness," "separation," and "natural." In their opinion, an ideal death was "dying without troubling those around them." As for the preferred place of terminal care, 41.9% of the respondents indicated their desire to spend the end of their lives at home. The conditions required to support death at home included "understanding and cooperation from family members," "support from the home doctor," and "support from the home care nurses." This suggests that home care nursing staff members who provide living support through home visitation have a central role in the home care medical system. When developing future community-based integrated care systems in communities where depopulation is occurring, the issues of proper matching and assessment of the convenience between the needs of the community residents who are to receive ca,re,and the availability of social resources from the wider community, must be taken into consideration

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