| 特集名 | 透析の導入・継続・中止 | |
|---|---|---|
| 題名 | 透析の継続 (3) 社会復帰の現状と問題点 | |
| 発刊年月 | 1998年 07月 | |
| 著者 | 山 親雄 | 増子記念病院 |
| 【 要旨 】 | 透析患者に対する支援の焦点は，長期生存・合併症対策から，高いQOLを目指したものへとシフトしつつある． そのなかで，就労年齢と考えられる60歳未満男性の就業率は75％に達している．しかしその収入は，3人に1人が国民1人当りの平均所得以下であり，過去5年間に就労を経験したうちの1/3が，主として病気を理由に，解雇または退職の経験を有している．より良い条件での就労の確保は，透析導入後では困難で，透析導入以前からの(あるいは保存療法開始以前からの)職業を継続することが望ましい．また，より良質な職場復帰を考えるなら，在宅血液透析の普及が必要と考える． 一方，透析患者の高齢化・長期化と糖尿病性腎症患者の増加に伴い，ADLあるいはIADLが低下し，通院時や，家庭生活でも介護を要する患者が増加している．家族による家庭内介護や，透析施設による支援も限界にきており，介護法の施行に併せて，透析患者の一部は，社会介護の適応となるであろう． |
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| Theme | Initiation, Maintenance and Discontinuation of Dialysis Therapy | |
|---|---|---|
| Title | Social activity in HD patients | |
| Author | Chikao Yamazaki | Masuko Memorial Hospital |
| [ Summary ] | A special concern for nephrologists in dialysis treatment has been attending to the prolongation of patients' survival, and prevention of dialysis complications, however, there has been a change in desired goals for nephrologists, with a greater emphasis being placed on QOL, at this time. At present, the percentage of patients returning to work is 75% in those less than 60 years. But, the amount for annual income for dialysis patients is less than the average national income in one third of the cases. Among patients who have returned to work for 5 years, one third of the patients have experienced either dismissal or retirement from work. The main reason being that they are undergoing dialysis. It is difficult to get new job, therefore, it is desirable for to continue their job is during dialysis treatment. One of the most important social problems surrounding dialysis treatment is impairment of aged patients' daily life. Those who have both an impairment of IADL and ADL, often need help from someone even in everyday life. There is a limitation to the care of patients by family members or the staff in dialysis centers. In these cases, some dialysis patients might need some type of social support system provided by the law (KAIGO-HOKEN-HOU). This law was recently established to provide care for disabled persons. | |