コロナ禍における多床室型の特別養護老人ホーム入居高齢者の発熱要因

Causes of Fever in Older Adult Residents of Multi-Bed Room-Type Nursing Homes amidst the Coronavirus Disease Pandemic

要　　旨

　本研究は、コロナ禍の特養入居者の発熱要因及び発熱の関連要因について明らかにすることを目的とした。多床室型の特養2施設に2021年から2022年の2年間、継続入居している人に対して、年齢、性別、基礎疾患、要介護度、日常生活動作、膀胱留置カテーテルの有無について発熱の有無との関連を解析した。研究参加の同意が得られた96名のうち、1年間で1回以上の診察を必要とした発熱者について、2021年は24人で平均発熱回数は1.58回、2022年は48人で平均発熱回数1.67回であった。発熱要因で多かったのは2021年は風邪症候群と尿路感染症、2022年は新型コロナウイルス感染症、風邪症候群、尿路感染症であった。解析の結果、2021年、2022年ともに要介護4以上の人は3以下の人よりも発熱割合が高いこととの関連がみられた。さらに感染予防行動を自らとりにくいという状態が発熱割合が高いことと関連している可能性の示唆が得られた。本研究結果は、多床室型の特養入居者の安全な生活環境について検討する際の資料になると考える。

　This study aimed to clarify fever causes in residents of nursing homes for older adults amidst the coronavirus disease (COVID-19) pandemic and the association between activities of daily living and fever onset.We analyzed the association of age, gender, underlying disease, level of care required, activities of daily living, and presence of indwelling bladder catheters with or without fever for those who were continuously residing in two multi-bed room-type nursing homes for older adults for two years, from 2021 to 2022. Of the 96 patients who gave consent to participate in the study, 24 had a fever requiring at least one doctor’s visit per year in 2021, with an average frequency of 1.58, and 48 had a fever in 2022, with an average frequency of 1.67. The most common causes of fever were cold syndrome and urinary tract infection in 2021, and new coronavirus infection, cold syndrome, and urinary tract infection in 2022. The analysis showed that in both 2021 and 2022, those who needed care level 4 or more were associated with a higher percentage of fever than those who needed care level 3 or less. Furthermore, it was suggested that a state in which people are less likely to take preventive measures against infection may be related to the high rate of fever. We believe that the results of this study can be used as a resource for considering a safe environment for older adult residents of multi-bed room-type nursing homes.