地域DOTS での高齢結核患者への服薬支援における保健師と関係者の連携の実態

The Status of Cooperation between Public Health Nurses and Related Professionals inProviding Medication Support for Older Adults with Tuberculosis in A Community-based Directly Observed Treatment Short-course (DOTS)

抄　　録

目的：地域DOTSでの高齢結核患者への服薬支援における保健師と関係者の連携の実態を明らかにする。

方法：保健師7名と保健師と連携した関係者（以下関係者）8 名に、半構造化インタビューを実施し、保健師と関係者との連携をコードとして抽出した。それらの類似性を横断的に比較し、保健師と関係者との連携の実態を整理した。

結果：保健師と関係者の連携の実態は、《顔の見える連携体制の基盤整備》、《結核患者支援に必要な正しい知識と情報の共有》、《サービスを活用した服薬支援体制の構築》、《個々の服薬課題に応じた服薬状況の管理》、《全身管理を含む包括的な療養状況の共有》が抽出された。

考察：保健師が関係者と円滑に連携していくには、早期から「顔の見える関係」を構築し、結核の正しい知識を啓発する必要がある。また、保健師と関係者の連携によって、サービスを活用し、高齢者の現存能力を生かした服薬支援と全身状態に応じた結核治療が可能となる。

Abstract

Objectives: This study clarified the status of cooperation between public health nurses and related professionals in providing medication support to older adults with tuberculosis in a community based-Directly Observed Treatment Short-course (DOTS).

Methods: Semi-structured interviews were conducted with seven public health nurses and eight related professionals. The codes for cooperation between public health nurses and related professionals were extracted from the interview contents. Themes regarding cooperation between public health nurses and related professionals were sorted by comparing inter-disciplinary similarities in the codes.

Results: The status of cooperation between public health nurses and related professionals was classified as follows: developing a foundation for face-to-face cooperation, sharing the knowledge and information required for providing support to patients with tuberculosis, building a medication support system with services, managing medication status according to individual issues, and sharing comprehensive treatment statuses, including physical monitoring.

Discussion: For public health nurses to cooperate smoothly with related professionals, establishing “faceto- face cooperation” may be necessary in the early stages. Moreover, these professionals should be provided with accurate knowledge about tuberculosis. Additionally, cooperation between public health nurses and related professionals enables the utilisation of services that meet the individual needs of older adults with tuberculosis. It further promotes medication support using older patients’ abilities and tuberculosis treatment that considers older adults’ physical condition.