認知症高齢者に対する効果的な口腔ケアに向けた文献検討

Literature Review on Effective Oral Health Care for the Elderly with Dementia

要旨

　目的：認知症高齢者の効果的な口腔ケアに向け，看護師が実践しているケアの現状と，それを踏まえた今後の課題について示唆を得るため，国内文献の知見を整理すること．

　方法：医学中央雑誌Web版（Ver. 5）とJDream IIIをデータベースとして，「認知症」「口腔ケア」をキーワードとして検索し，22件の原著論文を分析対象とした．

　結果：器質的口腔ケアに関するものが15件，機能的口腔ケアに関するものが7件であった．【器質的口腔ケア実践の問題点】【看護師による口腔ケアの工夫】【他職種による口腔ケアの工夫】【多職種連携による口腔ケアの効果】に分類された．

　結論：本研究結果による認知症高齢者の口腔ケアの現状から，看護師の認知症高齢者の口腔ケアに関する知識・技術をさらに向上させるための教育，認知症高齢者の口腔ケア実践において常に多職種連携が行える環境の確立と，その環境を整備する能力を看護師が身に付けることが，今後の課題であると考えられた．

　Purpose: The purpose of this study is to organize knowledge from the domestic literature for the effective oral health care of the elderly with dementia, and to get the suggestion about the actual state of the care that nurses are practicing and the forthcoming research problems in consideration of it.

　Methods: A literature search was conducted in two databases, the Japan Medical Abstract Society (JAMAS) and JDream III, using the keywords “Dementia” and “Oral Health Care”. As a result of the search, we included 22 original papers for analysis.

　Results: There were 15 papers about structural oral health care and 7 papers about functional oral health care. The result of the content analysis classified: “Problems of structural oral health care practice”, “Ingenuity of the oral health care by nurses”, “Ingenuity of the oral health care by other professionals” and “Ingenuity of the oral health care by multiple professionals”.

　Conclusion: In the actual state of oral health care for the elderly with dementia by the result of this study, it was suggested that the following attempts are forthcoming research problems: the education of nurses to improve knowledge and a technique about the oral health care of elderly with dementia, the environmental establishment for multiple professionals cooperation always available in oral health care practice, and the acquisition of ability of nurses to coordinate it.