臨牀透析 Vol.31 No.9(7)


特集名 維持透析患者の「満足度」を検証する
題名 透析患者の自殺,透析の継続中止
発刊年月 2015年 08月
著者 船越 哲 衆和会長崎腎病院
【 要旨 】 自殺の定義は,かつては自分の死に対する意思・ 自らの行為がもたらす結果予測性とされていたが,現在では「自殺意図の明確な自殺者は少なく,意志統御の混乱がむしろ彼らの特徴である」と,精神科疾患との強い関連が定着した.しかし,未だ自殺者の多くが精神科医を受診せず最期の時を迎えており,プライマリケアの場での精神障害の早期発見と精神科医への紹介が切望される.当院では,自殺予防のためには「透析施設は自殺予防介入の場」という意識をもち,患者の訴え(とくに死に関する話題)を傾聴することを鉄則としている.また自殺予防のためには医療従事者のみでなく,公的機関・社会資源の利用も有用と考える.
Theme Evaluating the chronic dialysis patients satisfaction
Title Prevalence of suicide in dialysis patients and withdrawal from dialysis
Author Satoshi Funakoshi Nagasaki Kidney Hospital
[ Summary ] Suicide was formerly considered to be an action which was "performing advisedly". However, it is now considered to be due to "insanity", indicating suicides are strongly associated with psychic disorders. However, many patients do not have the opportunity to consult with psychiatrists before they commit suicide. It is therefore of importance for primary care teams to focus on earlier detection and intervention when their patients exhibit depressive episodes. We are strongly convinced that dialysis facilities need to provide interventional functions for suicide prevention, and they must pay close attention to dialysis patients who suggest their own self inflicted deaths. Additionally, public organization and social resources may sometimes be useful tools for suicide prevention.
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