外来通院をしている高齢糖尿病患者のインスリン自己注射手技に影響を及ぼす要因

Factors Affecting Insulin Self-injection Procedure by Elderly Outpatients with Diabetes

要旨

目的：外来通院をしている高齢糖尿病患者がインスリン自己注射手技を正確に実施することに影響する要因を明らかにする．

方法：65歳以上の在宅にてインスリン自己注射を行っている糖尿病患者に対し，正確な自己注射手技に影響すると考えられる15の要因を独立変数，正確な自己注射手技の可否を従属変数として，ロジスティック回帰分析を行った．

結果：対象者は105名で，平均年齢は74.0±5.4歳であった．ロジスティック回帰分析の結果，正確な自己注射手技に関連していたのは，改訂長谷川式簡易認知評価スケールで評価した認知機能が高いこと（オッズ比1.16，95％信頼区間1.01〜1.33），看護師を中心とした医療従事者の支援があること（オッズ比6.35，95％信頼区間1.43〜28.28）であった．

結論：認知機能の低下があると，正確なインスリン自己注射手技が困難となる．しかし，看護師を中心とした医療従事者のサポートがあると正確な自己注射手技が実施できる可能性が高まることが示唆された．

Objective: This study was designed to identify the factors that affect the proper use of the insulin self-injection procedure by elderly outpatients with diabetes.

Methods: The current study included patients with diabetes aged 65 years or older who self-injected insulin at home. A logistic regression analysis was carried out to examine the 15 factors that could affect the proper use of the self-injection procedure as independent variables and the ability to self-inject insulin properly as a dependent variable.

Results: A total of 105 subjects with a mean age of 74.0 ± 5.4 years were included in the study. Based on the logistic regression analysis, high cognitive function as measured by Hasegawa's Dementia Scale-Revised (odds ratio: 1.16, 95% confidence interval: 1.01 to 1.33) and the presence of support from medical staff, mainly nurses (odds ratio: 6.35, 95% confidence interval: 1.43 to 28.28), were considered the factors associated with the proper use of the self-injection procedure.

Conclusion: Impaired cognitive function increases the likelihood of difficulty in self-injecting insulin. However, this study suggested that support from medical staff increased the likelihood of the proper use of the self-injection procedure.