療養病床を有する高齢者医療施設の退院支援における多職種連携についての職員の認識

Awareness among Staff Members of Multi-disciplinary Cooperation Involved in Discharge Planning at Medical Care Facilities for the Elderly with Long-term Care Beds

抄録

　本研究では，療養病床を有する医療施設の退院支援における多職種連携の認識や阻害要因に関する認識の職種間の違いを明らかにするため，無記名による自記式質問紙調査を実施した．職種間の認識の分析にはFisherの正確確率検定を用いた．その結果，同一の職種・部署内では連携できていると5割以上は認識していたが，医師と医師以外の職種間では，医師は連携できていると認識しているのに対して，逆は連携できていると認識していなかった．事務職と看護職・介護職，リハビリ職の職種間では，事務職は連携できていると認識しているのに対して，逆は連携できていると認識していなかった．リハビリ職と看護職・介護職，福祉職は双方に連携に困難を認識していた．看護職・介護職以外の職種・部署で有意差が認められた（p＜0.05）．医師と事務職は多職種参加の定期的なカンファレンスの定着と情報共有に困難を認識している割合が低く，職種間の価値や行動の違いは，すべての職種・部署で5割を超えていた．職種間の有意差は認められなかった（p＞0.05）．

　In this study, we implemented an anonymous self-reported questionnaire to clarify the differences between occupations in terms of awareness of multi-disciplinary cooperation and primary hindrances related to discharge planning at medical facilities with long-term care beds. Fisher's exact test was used to analyze the variations in awareness among occupations. The results showed that although over 50% of respondents felt there was cooperation in their occupation, in regards to cooperation between doctors and other occupations, doctors felt cooperation had been achieved with other occupations, whereas the other occupations did not share the same opinion. Although the clerks felt they had achieved cooperation with the nurses/care workers and rehabilitation therapists, the other occupations did not feel this was the case. Rehabilitation therapists and nurses/care workers/social welfare workers experienced mutual difficultly in cooperation. A significant difference was observed between occupations outside of nurses/care workers (p < 0.05). The proportion of doctors and clerks who felt there were difficulties in achieving multi-disciplinary information sharing and participation in regular conferences was low, and the differences in values and activity among occupations was over 50% for all occupations. A significant difference was not observed between different occupations (p > 0.05).