フィンランドとイギリスの地域における認知症高齢者と家族への服薬支援  [in Japanese] Providing Assistance in Drug Administration to Elderly with Dementia and Their Families in Finland and the UK  [in Japanese]

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Abstract

本研究の目的は,フィンランドならびにイギリスの地域における認知症高齢者と家族への服薬支援を明らかにし,日本の認知症ケアへの示唆を得ることである. フィンランドとイギリスの高齢者医療・ケアの専門職等24人に対して,認知症高齢者の薬物療法と服薬支援に関する半構造化面接を実施し,(1)国としての高齢者の薬物療法のシステム,(2)認知症の薬物療法の実施体制,(3)個々の認知症高齢者の服薬支援のための具体的方法,(4)認知症高齢者が適切に服薬するための家族への支援方法,(5)服薬支援に関する関係者間の連携方法について内容分析を実施した. フィンランドでは,薬物療法における情報の一元管理や看護職を対象とした薬物療法に関する教育プログラム,メモリーナースの自治体への配置が国レベルで展開され,看護職が個々の認知症高齢者の薬物療法を支援していた.イギリスでも,精神症状・行動障害は不適切なケアによって発症し,向精神薬は認知症高齢者の予後に不利益をもたらすことから,処方しないという対応が徹底されていた. さらに両国では,副作用を発見するために,家族や多職種によるモニタリングと連絡・相談が円滑にできる体制が整っていた. 日本においては看護師が認知症の薬物療法に関する専門性を高めて積極的に支援するとともに,副作用も含め処方薬に関する情報の集約と連絡・相談体制の構築,さらに多職種の連携による効果や副作用のモニタリングによって,向精神薬の低減を目指すことが必要であると示唆された.

The purpose of this research is to explore assistance provided in drug administration to elderly with dementia and their families in Finland and the United Kingdom (UK) to gain suggestions for dementia care in Japan.  Semi-structured interviews regarding drug therapy and assistance in drug administration to elderly with dementia were held with 24 professionals providing care and treatment to the elderly in Finland and the UK. Content analysis was conducted on (1) the nationwide drug therapy system for elderly, (2) the system for implementing drug therapy for dementia, (3) specific methods of assistance in drug administration for each elderly individual with dementia, (4) methods of assistance for families so that elderly with dementia appropriately take drugs, and (5) collaborative methods among relevant individuals regarding assistance with drug administration.  In Finland, unified management of information on drug therapy, education programs on drug therapy for nursing professionals, and placement of memory nurses in municipalities have been developed at the national level. Nursing professionals provide assistance with drug therapy for individual elderly patients with dementia. In the UK, psychotropic drugs are not prescribed since they are detrimental to the prognosis of elderly with dementia and psychiatric symptoms/behavioral disorders appear due to inappropriate care. Furthermore, in both countries there are established systems that enable the smooth implementation of monitoring and communication/consultation between families and various professionals for the purpose of discovering side effects.  This suggests there is a necessity in Japan for nurses to improve their expertise in drug therapy for dementia and actively provide assistance. In addition, systems should be created to gather information and provide communication/consultation on prescription drugs, including their side effects. Furthermore, a reduction in psychotropic drugs should be targeted by monitoring effectiveness and side effects through collaboration among various professionals.

Journal

  • 千葉大学大学院看護学研究科紀要

    千葉大学大学院看護学研究科紀要 (38), 1-10, 2016-03

    千葉大学大学院看護学研究科

Codes

  • NII Article ID (NAID)
    120005907164
  • NII NACSIS-CAT ID (NCID)
    AA12516447
  • Text Lang
    JPN
  • Article Type
    departmental bulletin paper
  • Journal Type
    大学紀要
  • ISSN
    2185-9698
  • NDL Article ID
    027211897
  • NDL Call No.
    Z19-996
  • Data Source
    NDL  IR 
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