| 特集名 | 高齢者の腹膜透析―assisted PDの現実と可能性 | |
|---|---|---|
| 題名 | assisted PDの現実と可能性（2）東京―アンケート調査から | |
| 発刊年月 | 2016年 09月 | |
| 著者 | 花岡 一成 | 東京慈恵会医科大学附属第三病院腎臓・高血圧内科 |
| 【 要旨 】 | 訪問看護ステーションなど在宅支援スタッフを活用した腹膜透析（PD）支援を行うため，島しょ部を除く東京都全域で訪問看護ステーション対象のアンケートを実施した．慢性腎臓病（CKD）の概念は浸透し，血液透析（HD）では多くの施設で対応可能である一方，在宅での手技を伴うPDは訪問経験施設が少なく，受け入れにも抵抗が多かった．また，PD受け入れ可能施設の比率に地域格差がみられ，基幹病院との連携の違いが反映していることが示唆され，PD在宅支援の促進には顔の見える地域連携システムの構築が重要であることがわかった．さらに今後は，介護家族への精神的・肉体的負担に配慮しつつ，より長期に在宅治療が継続できるような環境整備が必要である． | |
| Theme | PD for elderly patients -- current status of "assisted PD" and its future perspective in Japan | |
|---|---|---|
| Title | Actual and potential use of assisted PD : a questionnaire survey in Tokyo | |
| Author | Kazushige Hanaoka | Division of Nephrology & Hypertension, The 3rd Hospital of the Jikei University School of Medicine |
| [ Summary ] | When elderly people become patients with end-stage renal disease (ESRD), they often experience many complications. Peritoneal dialysis (PD) has several benefits for elderly patients, such as reduced need for clinic visits and easier control of food and water intake. However, there are some issues to account for when conducting PD, for example, physical disabilities and psychosocial problems in patients and lack of family members to assist in the operation of PD. If home-visiting nurses can help treat patients at home (assisted PD), some of these problems may be solved. We conducted a questionnaire survey to determine Tokyo home-visiting nursing stations' opinions about CKD and assisted PD. The results indicated that many home-visiting nursing stations neither recognized nor were ready to participate in PD therapy. Some stations were already involved in priming and changing PD bags, but most of them remained limited to checking general conditions and exit-site infections. The reasons why they hesitated to participate in assisted PD were anxiety about possible emergency conditions and a lack of trusting relationships with attending nephrologists. We have now tried to establish trusting relationships with home-visiting nursing stations through case study conferences and lecture courses. Some of the stations participate in the meetings and have become interested in assisted PD. |
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