災害時支援透析に必要な患者情報と治療条件に関する基礎的研究  [in Japanese] Patient- and Treatment-related Information Needed for Temporary Dialysis Treatment Provided outside Disaster-Stricken Areas  [in Japanese]

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Author(s)

    • 髙橋 純子 Takahashi Junko
    • 東海学院大学健康福祉学部|北陸大学新学部設置準備室 Faculty of Health and Welfare, Tokai Gakuin University|New Faculty Establishment and Planning Office, Hokuriku University

Abstract

<p>本研究の目的は,災害発生直後から1か月後までの災害急性期および亜急性期に,被災施設の透析患者を一時的に受け入れて透析治療を実施する支援透析において必要な患者情報および透析治療に必要な情報を明らかにし,支援透析先でも迅速で安全な治療を行うための基礎資料を構築することである。</p><p>無作為抽出した500の透析施設に対して①支援透析の経験の有無,②災害急性期/亜急性期に被災施設から支援透析施設へ提供された患者情報と透析治療条件,③災害急性期/亜急性期に支援透析を実施する際に必要な患者情報と透析治療条件およびその必要度を調査した。また,対象施設を支援透析の経験の有/無に群分けし,災害急性期/亜急性期の患者情報と透析治療条件の必要度を比較した。</p><p>その結果,情報の必要度の平均点が高い項目として,災害急性期では「患者氏名」,「感染症の有無」,「ドライウェイト」,「抗凝固薬」,「ブラッドアクセスの種類」,「ダイアライザーの名称」の6項目が抽出された。災害亜急性期では,急性期の6項目に加え「定期注射薬の種類」,「服薬情報」,「血液流量」,「穿刺部位」の4項目が新たに抽出された。</p><p>支援透析の経験の有/無が患者情報と透析治療条件の必要度に与える影響についての分析では,災害急性期において「透析時間」,「定期注射薬の種類」,「血液流量」,「透析液流量」,「設定除水速度」の5項目で支援透析の経験がある施設のスコアが有意に高かった。</p><p>本結果より,経験や推測により考えられていた支援透析に必要な情報が複数施設の有識者の意見と一致したことで,災害時に欠くことのできない情報であることが示唆された。また,不足している情報も明らかとなり,今後その情報の必要性を多くの施設に認知させることが必要である。</p>

<p>In the acute and post-acute phases of a disaster, or the period immediately after disasters to one month the after, it is often necessary to temporarily transfer dialysis patients to other areas stricken by the disaster to provide them with care. This study aims to discuss patient and other information necessary for dialysis treatment, and provide basic knowledge required to implement prompt and safe treatment.</p><p>The following items were examined, involving 500 randomly selected dialysis facilities : 1) the experience of dialysis treatment provided outside disaster-stricken areas, 2) contents of patient- and treatment-related information provided by affected facilities to those providing dialysis treatment, and 3) details of patient- and treatment-related information needed for dialysis treatment provided outside disaster-stricken areas during the acute and post-acute stages, as well as the importance level of such a need. Furthermore, the importance levels of need for patient- and treatment-related information during the acute and post-acute stages were compared between facilities with and without experience of dialysis treatment.</p><p>As a result, information regarding the following items was markedly needed during the acute stage : <the name of the patient>, <presence/absence of infection>, <dry weight>, <anticoagulants>, <type of blood access>, and <name of the dialyzer>. In addition to these, the following items were also extracted as the contents of information markedly needed during the post-acute stage : <the type of regular injection drugs>, <medication>, <blood flow volume>, and <site of needle insertion>.</p><p>On comparing the level of need for patient- and treatment-related information between facilities with and without experience of providing dialysis treatment outside the stricken areas for patients who had experienced a disaster, the former showed significantly higher mean values for <the duration of dialysis>, <type of regular injection drugs>, <blood flow volume>, <dialysis liquid flow volume>, and <set fluid removal velocity> as the contents of information needed during the acute stage.</p><p>The results suggest that information regarding the above-listed items, which had previously been regarded as necessary for temporarily dialysis treatment based only on experience or estimation, is actually indispensable during disasters, as noted by experts from various facilities. The details of insufficient information were also clarified, indicating the importance of enhancing awareness of the necessity of such information among facilities.</p>

Journal

  • JOURNAL OF JAPAN HEALTH MEDICINE ASSOCIATION

    JOURNAL OF JAPAN HEALTH MEDICINE ASSOCIATION 25(Supplement), 287-295, 2016

    JAPAN HEALTH MEDICINE ASSOCIATION

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