COVID-19感染拡大下における看護師が捉えた糖尿病患者の療養生活の困難さと心理的苦痛に関する実態調査

Fact-finding survey on the difficulties and psychological distress of patients with diabetes receiving medical treatment at home under the spread of coronavirus disease 2019 infection as perceived by nurses

　本研究の目的は，看護師が捉えたCOVID-19感染拡大下における糖尿病患者の療養生活の困難さと心理的苦痛を明らかにすることである．

　調査は，慢性疾患看護専門看護師または糖尿病看護認定看護師に対し1施設1回答とし，無記名式質問紙によるWEB調査を実施した．調査内容は，COVID-19感染拡大下における糖尿病患者の療養生活における苦労や不安等であり，自由記述内容を質的帰納的に分析した．結果，有効回答数は174であった．看護師が捉えた療養生活の困難さと心理的苦痛は【良好な糖尿病の疾患管理を目指す療養生活を継続する上での困難さ】，【高齢糖尿病患者にもたらされた療養生活維持の困難さ】，【自身がCOVID-19に感染したことで生じた困難さ】，【療養生活が脅かされる不安】，【自粛生活に伴う孤独感や悲哀】，【療養生活への意欲低下】，【感染予防対策への負担感】の7つのカテゴリーが導出された．

　糖尿病患者が，COVID-19感染拡大下で従来の療養生活を営むことは，様々な困難さや心理的苦痛をもたらす．看護師は，患者の状況に応じた速やかな判断と支援体制を整える能力を養うことが求められる．

　The purpose of this study was to determine the difficulties and psychological distress of patients with diabetes receiving medical treatment at home under the spread of coronavirus disease 2019 (COVID-19) infection as perceived by nurses.

　An anonymous questionnaire survey was conducted via the Internet on certified nurse specialists in chronic care nursing or certified nurses in diabetes nursing once per facility. The contents of the survey were the difficulties and anxieties of medical treatment at home of patients with diabetes under the spread of COVID-19 infection, and the free descriptions were analyzed by qualitative inductive analysis.

　Data from 174 participants were analyzed. The following seven categories of difficulties and psychological distress in medical treatment at home as perceived by nurses were derived: [Difficulties in continuing medical treatment at home aimed at good diabetes disease management], [Difficulties in maintaining medical treatment at home in elderly patients with diabetes], [Difficulties caused by his own infection with COVID-19], [Anxiety that threatens medical treatment at home], [Loneliness and sadness associated with a life of self-restraint], [Decreased motivation to receive medical treatment at home], and [Sense of burden for infection prevention measures].

　The conventional medical treatment at home for patients with diabetes under the spread of COVID-19 infection causes a variety of difficulties and psychological distress. Therefore, nurses must develop the ability to establish a prompt support system for the patient's situation.