災害時要配慮者の避難支援に関する検討―パーキンソン病生活機能障害度１度の在宅療養者の場合

Emergency evacuation support for individuals requiring assistance during disasters: Focusing on home-based Parkinson's disease patients with Stage 1 functional disabilities

要約

【目的】パーキンソン病（以下、PD）生活機能障害度1度「日常生活、通院にほとんど介助を要しない（以下、1度）」在宅療養者に焦点をあてて、災害に関する認識、避難支援の必要性を検討した。

【方法】東日本地域8県のPD友の会会員全数978人に対して、無記名郵送自記式質問紙調査を2013年に実施し、1度141人を分析対象とした。質問項目は属性、避難等の27項目で、それらを単純集計とχ²検定を用いて比較検討した。

【結果】今後の被災可能性は「思う」48.2％、自力・同居家族のみでの避難は困難と思うか「思う」45.4％、災害発生時に逃げ遅れると思うか「思う」62.4％であった。同居家族以外の避難支援者が「有り」34.0％、支援者は隣近所、親戚兄弟の順に多かった。

【考察及び結論】2013年改正の災害対策基本法の避難行動要支援者は、要介護3以上の在宅生活者を想定しており、1度は対象外である。しかし、「自力、家族の協力のみでは避難が困難と思う」は半数程度存在し、少なくても避難の呼び掛けや安否確認等は必要であり、要配慮者の安否確認名簿等の整備と在宅療養者が災害時の避難方法を考え、自助を促す看護が必要なことが示唆された。

[Purpose] To descriptively analyze disaster awareness and the need for emergency evacuation support for patients with Parkinson's disease (PD) who “require little or no assistance with visiting hospitals and daily activities” (Stage 1 functional disabilities).

[Methods] In 2013, anonymous self-administered questionnaires were sent to all members of PD support groups (n=978) operating in eight prefectures located in eastern Japan, and responses from 141 patients with Stage 1 functional disabilities were used for analysis. The question were 27 items about attribute and the refuge. Analysis was conducted using the chi-square test.

[Results] A total of 48.2, 45.4, and 62.4% of the patients responded that “there is a possibility of being affected by a disaster in the future,” “it would be difficult to evacuate by myself or only with the assistance of my family members,” and “I may not be able to escape in the event of a disaster,” respectively. Thirty-four percent of the patients responded that they have someone to assist them other than family members in an emergency; such supporters include their neighbors, which accounted for the majority, followed by their relatives.

[Discussion and Conclusion] According to the revised Basic Act on Disaster Control Measures (2013), people in need of assistance during disasters are defined as individuals receiving care athome with a care requirement level of 3 or higher, and those with Stage 1 functional disabilities are excluded. However, approximately half of the respondents felt that “it would be difficult to evacuate by myself or only with the assistance of my family members,” suggesting there is a need to at least notify them about impending evacuation and confirm their safety, as well as a need to develop a safety confirmation list of individuals who require assistance during disasters, examine methods of evacuation for home-based patients, and provide nursing care to promote self-help.