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本研究は,COVID-19感染拡大下での入院中の糖尿病患者への教育・看護の実態を明らかにすることを目的とした.入院病床がある医療機関に所属する慢性疾患看護専門看護師および糖尿病看護認定看護師を対象にWeb調査を実施し,記述統計と質的帰納的手法により分析した.
有効回答数は184名で,感染拡大により糖尿病患者の入院を制限した時期があった施設は57.6%,糖尿病教室の件数が減少した施設は63.0%であった.病棟における教育・指導の変更に伴う問題は【面会制限による家族指導の困難さに伴う療養継続の困難】【糖尿病患者の教育・療養環境の悪化】【COVID-19対策に伴う教育の質の低下】などが,対応策・工夫点は【面会制限下での指導機会や方法,場所の変更を伴う家族への指導の工夫】【対面指導に代わる教育資材の工夫】【COVID-19感染に関する教育内容の追加】【病棟と外来の接触の回避による感染機会の最小化】などがあった.
COVID-19感染拡大下においても,糖尿病看護の質を保証する体制づくりの必要性が示唆された.
This study aimed to determine the actual conditions of education and nursing of patients with diabetes hospitalized during the COVID-19 pandemic. A web-based survey was conducted on Certified Nurse Specialists in Chronic Care Nursing and Certified Nurse in Diabetes Nursing in inpatient medical facilities. Quantitative data were analyzed using descriptive statistics,and qualitative data were analyzed using qualitative inductive methods.
Data from 184 participants were analyzed. Among the facilities,57.6% had restricted hospitalization for patients with diabetes at some time to prevent the spread of infection,and 63.0% had decreased the number of educational classes for patients with diabetes. Educational and nursing problems due to the spread of COVID-19 included:difficulty in continuing self-care due to inability to provide guidance to family members because of visitation restrictions,deterioration of the educational and self-care environments of patients with diabetes,and decrease in the quality of education due to COVID-19 measures. The measures and ingenuities included the following:providing guidance to patients' family members under visitation restrictions,devising educational materials to replace face-to-face instruction,adding educational content regarding COVID-19,minimizing risk of infection by restricting contact between hospitalized patients and outpatients.
The findings suggest the necessity to create a system to assure the quality of diabetes nursing even under conditions such as the COVID-19 pandemic.
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