通所介護のスタッフにおける認知症高齢者の行動・心理症状への遭遇頻度および対応困難感の実態

Frequency of Encountering Behavioral and Psychological Symptoms and Perceived Difficulties in Responding to Them among Older People with Dementia in Day-care Centers

要　　旨

　本研究は、通所介護を利用する認知症高齢者が有する行動・心理症状（Behavioral and Psychological Symptoms of Dementia：BPSD）のうち、通所介護事業所の看護職員・介護職員（以下スタッフ）がBPSDに遭遇する頻度、および対応に困難を感じているBPSDを質問紙調査を用いて明らかにした。A市内の通所介護事業所の管理者187名、看護職員148名、介護職員183名の回答を分析した。結果、スタッフが遭遇する頻度が高いBPSDは易刺激性、異常行動、日内リズム障害、アパシーであり、通所介護事業所の種類や利用人数等が遭遇頻度に関連すると示された。スタッフが対応に困難を感じるBPSDは興奮、易刺激性、攻撃性、妄想であり、スタッフの当該事業所における勤務年数が対応困難感に関連すると示された。一方、職種や年齢による対応困難感の有意な差はみられなかった。今後、スタッフが対応困難に感じるBPSDに対し有効なケア方法を検討し実施していくことで、スタッフの対応困難感の軽減が可能であると推察された。

　The purpose of this study was to clarify the frequency of BPSD encountered by nursing and care staff in day-care centers and the BPSD that they feel difficulty in dealing with. A questionnaire survey was conducted, and responses were obtained from 187 facility manager, 148 nursing staff, and 183 care staff at day-care centers in A city. Result indicated that the symptoms most frequently encountered by the staff were irritability, abnormal behavior, circadian rhythm disorder, and apathy. The factors affecting the symptoms were the type of day-care center and the number of users. The symptoms most difficult to deal with were agitation, irritability, aggression, and delusion. A related factor was the number of years' experience of staff working at the day-care center. On the other hand, there was no significant difference depending on the type of job or age. It is inferred that effective care methods for BPSD that staff members find difficult to cope with can be studied and implemented to reduce the sense of difficulty.