介護老人保健施設における認知症高齢者への多職種連携による摂食困難ケアとその影響要因—認知症高齢者の食事課題や多職種連携に関する認識に着目して

Interdisciplinary Collaboration in Dysphagia Care for Older People with Dementia in Health Service Facilities for the Elderly Requiring Long-term Care and Its Influencing Factors—Understanding Dietary Challenges and Interdisciplinary Collaboration in Older People with Dementia

抄録

　介護老人保健施設における認知症高齢者への多職種連携による摂食困難ケアとその影響要因について明らかにすることを目的とした．2021年12月〜2022年1月，東北6県に所在する老健に従事する職員を対象に質問紙調査を行った．多職種連携による摂食困難ケアの下位尺度（多面的なアセスメントと個別的ケア，満足感への配慮，対象者の把握）を従属変数とし，個人属性，施設特性, 認知症高齢者の食事課題と多職種連携に関する認識を独立変数としたステップワイズによる重回帰分析を行った．分析対象者は254人であった．分析の結果，多職種連携による摂食困難ケアには「研修経験」「他職種と情報共有の必要性」「多職種連携による改善可能」が影響していた．多職種連携の有効性を実感することはもとより，研修による認知症高齢者の意思尊重やチームでのケア統一の重要性を理解することが多職種連携による摂食困難ケアに影響すると結論づけられた．

　The aims of this study were to investigate interdisciplinary collaboration in dysphagia care for older people with dementia in long-term care facilities and identify factors influencing this collaboration. Conducted between December 2021 and January 2022 in the Tohoku region of Japan, the research involved a questionnaire survey administered to staff members at geriatric health service facilities in six prefectures. The results revealed dependent variables related to dysphagia care through interdisciplinary collaboration, including comprehensive assessment and individualized care, consideration for satisfaction, and understanding of the target individual. Independent variables included demographic factors, facility characteristics, perceptions regarding eating challenges in older people with dementia, and awareness of interdisciplinary collaboration. Data from 254 staff members were subjected to stepwise multiple regression analysis. The results revealed that factors influencing dysphagia care through interdisciplinary collaboration included “training experience,” “necessity of information sharing with other professions,” and “potential improvement through interdisciplinary collaboration.” These findings indicate that recognizing the effectiveness of interdisciplinary collaboration, understanding the importance of respecting the autonomy of older people with dementia through training, and ensuring care consistency within the team significantly impact the quality of dysphagia care through interdisciplinary collaboration.