日本における頻繁な訪問と支援の調整を必要とする家庭訪問看護ステーションと精神病院の家庭訪問看護サービスの利用者の特徴
Mami Kayama1, Yoshifumi Kido2, Akiko Funakoshi3
1National College of Nursing, Japan Institute for Health Security, Tokyo, Japan.
Global health & medicine
|September 2, 2025
まとめ
日本では,統合失調症や機能不全などの複雑な精神疾患の患者を対象に,頻繁に精神病院を訪問する看護師がいます. これらの患者には最適な治療結果を出すために 調整された支援と 個別的なケア計画が必要です
科学分野:
- 精神科
- 介護
- 医療サービス研究
背景:
- 精神科の家庭訪問看護は,精神保健医療に不可欠であるが,日本では,歴史的に制度的に集中しているため,開発が遅れている.
- 精神科の家庭訪問看護の実施を改善するには,サービス利用者のプロフィールを理解することが重要です.
研究 の 目的:
- 日本におけるホーム訪問看護ステーションからの頻繁な訪問 (≥3回/週) を必要とするサービス利用者を特徴付け,調整を支援する.
- 精神科のホーム訪問看護における需要の高い使用者と関連した要因を特定する.
主な方法:
- 2024年10月から2025年1月までアンケート調査が行われました.
- 日本の56の家庭訪問看護ステーションと224のサービスユーザーから収集されたデータです.
- 使用者はケアパターンに分類されます. 頻繁な訪問のみ,協調のみ,または両方.
主要な成果:
- 使用者の15.6%は,施設の種類によって異なる,週に3回以上の家庭訪問を受けた.
- 統合失調症,長期使用,併発症,機能低下 (GAF平均41. 9) と関連した頻繁な訪問
- 高度な必要性のある使用者 (頻繁な訪問 + 調整) は,最も低いGAF,最も高い症状の重症度 (幻覚,衝動性,自傷) を示した.
結論:
- 精神科の自宅訪問看護の利用者は複雑で多様なニーズがあり,調整とリソースの割り当てが求められます.
- 組織化された個別化されたケア計画と 文書化された合理的根拠は不可欠です
- この研究は,精神科の家庭訪問看護における日本の政策と実践の発展のための基礎データを提供します.
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