急性期病院の脳神経疾患患者に対する口腔ケアニーズの分析  [in Japanese] Analyses of Oral Health Care Needs of Hospitalized Patients with Neurological Disorders  [in Japanese]

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Author(s)

    • 吉岡 昌美 YOSHIOKA Masami
    • 徳島大学歯学部口腔保健学科:徳島大学医学部・歯学部附属病院歯科衛生室 School of Oral Health and Welfare, Faculty of Dentistry, The University of Tokushima:Dental Hygiene Section, Tokushima University Medical and Dental Hospital
    • 日野出 大輔 HINODE Daisuke
    • 徳島大学歯学部口腔保健学科:徳島大学医学部・歯学部附属病院歯科衛生室 School of Oral Health and Welfare, Faculty of Dentistry, The University of Tokushima:Dental Hygiene Section, Tokushima University Medical and Dental Hospital
    • 藤井 裕美 [他] FUJII Hiromi
    • 徳島大学医学部・歯学部附属病院診療支援部 Division of Medical Technology, Tokushima University Medical and Dental Hospital
    • 廣瀬 薫 HIROSE Kaoru
    • 徳島大学医学部・歯学部附属病院診療支援部 Division of Medical Technology, Tokushima University Medical and Dental Hospital
    • 坂本 治美 SAKAMOTO Harumi
    • 徳島大学医学部・歯学部附属病院診療支援部 Division of Medical Technology, Tokushima University Medical and Dental Hospital
    • 十川 悠香 SOGAWA Yuka
    • 徳島大学医学部・歯学部附属病院診療支援部 Division of Medical Technology, Tokushima University Medical and Dental Hospital
    • 松本 尚子 MATSUMOTO Naoko
    • 徳島大学歯学部口腔保健学科 School of Oral Health and Welfare, Faculty of Dentistry, The University of Tokushima
    • 星野 由美 HOSHINO Yumi
    • 徳島大学歯学部口腔保健学科 School of Oral Health and Welfare, Faculty of Dentistry, The University of Tokushima
    • 福井 誠 FUKUI Makoto
    • 徳島大学医学部・歯学部附属病院歯科衛生室:徳島大学大学院ヘルスバイオサイエンス研究部予防歯学分野 Dental Hygiene Section, Tokushima University Medical and Dental Hospital:Department of Preventive Dentistry, Institute of Health Biosciences, The University of Tokushima Graduate School
    • 横山 正明 YOKOYAMA Masaaki
    • 徳島大学医学部・歯学部附属病院歯科衛生室:徳島大学医学部・歯学部附属病院口腔管理センター Dental Hygiene Section, Tokushima University Medical and Dental Hospital:Oral Health Management Center, Tokushima University Medical and Dental Hospital

Abstract

われわれは,平成16年より徳島大学病院栄養サポートチームの一員として病棟における専門的口腔ケアを展開してきた,当初より,脳神経疾患をもつ患者の占める割合が多く,平成20年2月までの間,計143名の当該患者の口腔ケアを行った.本研究では,これらの患者の初診時における口腔内状態および全身状態について調査し,口腔ケアのニーズにかかわる要因について統計学的に検討した.その結果,約80%の人が「口腔周囲筋や舌の動き」が十分でなく,約60%の人に「口腔乾燥」の発現や「意識レベル」の低下を認め,約25%の人に「不随意の常時開口」がみられた.ロジスティック回帰分析の結果,「口腔乾燥」の強さが多量の「不潔物付着」に強く寄与することが示唆された.また,「口腔乾燥」の強さは「常時開口」がみられる,「うがい」が不可能あるいは不十分,「口腔周囲筋や舌の動き」が低下,「意識レベル」が低下,といった脳神経疾患患者で高頻度にみられる所見と有意な関連を示すことが確かめられた.これらのことから,意識レベルの低下および常時開口がみられる患者に対しては,急性期から口腔乾燥を予防するとともに良好な口腔衛生状態の保持に努め,口腔機能にも配慮した専門的口腔ケアを行っていく必要性が示唆された.

The purpose of the present study was to identify factors related to oral health care among inpatients with neurological disorders. For each of the 143 inpatients included in our study, the oral as well as general health (level of consciousness, feeding style, etc.) conditions were investigated using an assessment sheet at their first visit. The study revealed that 80% of the hospitalized patients showed "dysfunction of oral periphery muscle and/or tongue movement", 60% of them presented "dry mouth" and/or a "reduced level of consciousness", and 25% exhibited "constant open mouth with no intention". By logistic regression analysis of the data, it was strongly suggested that "severe debris accumulation" could be attributed to "dry mouth". Furthermore, "dry mouth" was found to be significantly correlated with several features, including "constant open mouth", "impaired mouth rinse", "dysfunction of oral periphery muscle and/or tongue movement", and "reduced level of consciousness", which are conditions often observed in patients with neurological disorders. These results suggest that inpatients with both a "reduced level of consciousness" and "constant open mouth" should receive professional oral care in order to prevent "dry mouth", and undergo a careful follow-up to promote the maintenance of good oral hygiene and functions.

Journal

  • JOURNAL OF DENTAL HEALTH

    JOURNAL OF DENTAL HEALTH 58(5), 490-497, 2008

    Japanese Society for Oral Health

References:  20

Cited by:  4

Codes

  • NII Article ID (NAID)
    110006990074
  • NII NACSIS-CAT ID (NCID)
    AN00081407
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0023-2831
  • NDL Article ID
    9706265
  • NDL Source Classification
    ZS44(科学技術--医学--歯科学・口腔外科学)
  • NDL Call No.
    Z19-144
  • Data Source
    CJP  CJPref  NDL  NII-ELS  J-STAGE 
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