介護保険施設における入浴ケア体制の実態調査

Investigation into the Actual Conditions of Bathing Care System in Long-term Care Facilities

抄録

　利用者の重度化が進む介護保険施設において，入浴ケアは高温・多湿の環境下で行われる，介助者の負担が大きいケアのひとつである．本研究では，介護保険施設における入浴ケア体制の実態を明らかにし，介助者の負担に影響する課題を検討することを目的とした．方法は，介護保険施設計342施設に対し，質問紙を郵送し，入浴ケア体制に関する内容について，ケア管理者に回答を依頼した．その結果，156施設から回答が得られた（回収率45.6％）．介護老人福祉施設では，1人用の浴槽を設置している施設が多く，マンツーマンでのケアを行っている施設が介護老人保健施設，介護療養型医療施設に比べて多い傾向がみられた．また，介助者が1勤務帯に入浴ケアに携わる時間は，200分以下が半数以上を占めていたが，300分以上の施設もみられ，3施設間で違いはみられなかった．これらのことから，介護保険施設における入浴ケアは，利用者の重度化に伴い長時間を要しており，介助者の負担の一因となっていることが考えられた．

　In long-term care facilities, the users' conditions are often severe and are likely to get progressively worse, leading to the need for more care services. Bathing care is one of the services that put a heavy burden on the caregiver, as it is performed in a high temperature and high humidity environment. The purpose of this study was to clarify the actual conditions of the bathing care system and examine the issue of burden of care in long-term care facilities.

　A questionnaire was mailed to the care administrators of 342 institutions. The survey content was on the bathing care time and system. Replies were obtained from 156 institutions (45.6%). We found that a high percentage of welfare facilities for the elderly (Tokuyo) had bathtubs for individual bathing. Also, these places were providing more one-to-one bathing care services than the geriatric health service facilities (Roken) or medical long-term care sanatoriums (Ryoyo-gata). Independent of the type of the facility, about half of them replied that the time caregivers spent on bathing care per shift was less than 200 minutes, but there were facilities that said it was more than 300 minutes. The results suggest that the caregivers at all types of long-term care facilities are required to spend a long time doing bathing care. This may be due to the severity of the users' conditions, and may lead to a heavy physical and mental burden on caregivers.