入院中の末期がん患者の在宅療養移行の実現と患者・家族の状況および看護支援・他職種連携との関連性の検討―在宅療養移行を検討した患者を対象とした二次分析の結果

Assessment of Factors Related to Implementation of Transfer of Terminal Cancer Inpatients to a Home Care Setting within Patient/Family Related Factors and Nurse/Multidisciplinary Team Related Factors：A Secondary Analysis Targeted for the Potential Inpatients of Transfer to a Home Care Setting

要旨

　本研究では，入院中の末期がん患者の在宅療養移行の実現と，患者・家族の状況および看護支援・連携の状況との詳細な関連を明らかにするために，研究の全対象である53病院82病棟の末期がん患者464例のうち，在宅療養移行の検討を行った155例に限定した二次分析を実施した．病棟看護師に対して質問紙郵送調査を行い，ロジスティック回帰分析にて在宅療養移行の実現・非実現への関連要因を検討した．その結果，患者・家族の状況のうち，患者が入院中に点滴をしていないこと，酸素療法を受けていないこと，食事の介助が必要でないこと，および家族の在宅療養の希望があること，また，看護支援・連携の状況のうち，受け持ち看護師が，緊急時の連絡体制・受入体制の保証を説明していること，および訪問看護師と連携をとっていることの計6項目が関連要因として示された．本研究にて明らかにされた各要因の整備により，在宅療養へ移行できるがん患者の増加が望まれる．

Abstract

　This study conducted a secondary analysis to clarify factors related to the implementation of transfer of terminal cancer inpatients to a home care setting within the patient/family related factors and nurse/multidisciplinary team related factors. The subjects were 155 potential inpatients of transfer to a home care setting among the recruited 464 cancer inpatients in 53 hospitals, 82 units. We conducted a questionnaire survey by mail of hospital unit nurses responsible for the care of terminal cancer patients and assessed factors related to implementation of transfer of terminal cancer inpatients to a home care setting by logistic regression analysis. The results revealed a total of 6 items as related factors: Patient condition being absence of intravenous therapy, absence of oxygen therapy, having no need to support of eating, having desire by the family for home care, nurses responsible informing guarantee for 24 hour support system of the hospital to patients, and nurses responsible having a relationship with home care nurses. In the future it is hoped that an environment will be created in which greater importance is attached to each of the factors identified in this study.