がん診療連携拠点病院のソーシャルワーカー・退院調整看護師から見た緩和ケア病棟転院の障壁  [in Japanese] Barriers of Transfer to Palliative Care Units in Core Cancer Hospitals from the Viewpoint of Medical Social Workers and Discharge Support and Coordination Nurses  [in Japanese]

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Author(s)

    • 長岡 広香 Nagaoka Hiroka
    • 筑波大学附属病院総合診療科緩和ケアセンター Center for Palliative and Supportive Care, University of Tsukuba Hospital
    • 坂下 明大 Sakashita Akihiro
    • 神戸大学医学部附属病院緩和支持治療科 Department of Palliative Medicine, Kobe University Graduate School of Medicine
    • 濵野 淳 Hamano Jun
    • 筑波大学医学医療系 Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba
    • 岸野 恵 Kishino Megumi
    • 神戸大学医学部附属病院腫瘍センターがん相談室 Cancer Information and Support Services, Cancer Center, Kobe University Hospital
    • 岩田 直子 Iwata Naoko
    • 筑波大学附属病院医療連携患者相談センター Center for Medical Social Service Center, University of Tsukuba Hospital
    • 福地 智巴 Fukuchi Tomoha
    • 神奈川県立がんセンター緩和ケア・患者支援部患者支援センター Department of Palliative Care / Patient Support, Patient Support Center, Kanagawa Cancer Center
    • 志真 泰夫 Shima Yasuo
    • 筑波メディカルセンター病院緩和医療科 Department of Palliative Medicine, Tsukuba Medical Center Hospital
    • 木澤 義之 Kizawa Yoshiyuki
    • 神戸大学医学部附属病院緩和支持治療科 Department of Palliative Medicine, Kobe University Graduate School of Medicine

Abstract

<p>緩和ケア病棟への転院に関する障壁を明らかにすることは,がん患者が望んだ場所で療養できる体制の整備を通して,quality of lifeへの寄与が期待できる.本研究では,がん終末期患者の緩和ケア病棟転院の障壁を明らかにすることを目的に,がん拠点病院424施設のソーシャルワーカー・退院調整看護師を対象に自記式質問紙調査を行った.探索的因子分析により,緩和ケア病棟への転院の障壁11因子が同定された.病状・予後に関して医師から患者に十分説明を行うこと,適切な時期に気持ちの配慮をしながら多職種で意思決定し緩和ケア病棟に紹介すること,がん拠点病院と急性期病院,緩和ケア病棟,在宅等の地域の医療機関との緩和ケア連携体制を整備すること,緩和ケア病棟への入院が必要な患者を適切に評価する仕組みを作ることは,ソーシャルワーカー・退院調整看護師から見た緩和ケア病棟転院の障壁を軽減する可能性があると考えられた.</p>

<p>Identifying barriers regarding cancer patients' transfer to palliative care units (PCUs) should help improve their quality of life and enable them to choose where to recuperate. The present study sought to define these barriers using a self-completed questionnaire survey of medical social workers and nurses at the discharge support and coordination departments of 424 cancer care hospitals nationwide. By exploratory factor analysis, Identified barriers to PCUs transfer included 11 domains. Our study suggested that the barriers experienced by medical social workers and nurses at the discharge support and coordination departments regarding transfer to PCUs can be reduced by sufficient explanation by physicians to patients, timely PCUs referral with psychosocial consideration, improvement of collaborative system in between cancer care hospitals nationwide, general hospital, PCUs and home medical care, clarifying adequate structure to identify the patient who needs admission to PCUs. </p>

Journal

  • Palliative Care Research

    Palliative Care Research 12(4), 789-799, 2017

    Japanese Society for Palliative Medicine

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