Study of difficulty of home care ostomy patients who are using visiting nurse system

本研究旨在了解造口病人居家护理的困难及需求。目的：找出造口病人更好的医院及居家护理系统存在的问题。方法：研究一，病人组(日本造口协会及IBD病人组)，采用问卷调查法。研究二采用问卷调查法，调查内容包括护理职业和人口学资料、造口护理相关因素、造口病人的保健问题。研究一，对205名造口协会会员和685名IBD患者进行数据分析：研究2，向造口护理护士发放问卷1115份，回收有效问卷1034份(92.7%)，高技能护理教育需求依次为：L)造口部位标识，2)造口器材选购，3)自我护理教育。实际操作中造口患者的保健问题比例较高，1)癌症复发，2)老年护理问题，3)癌症疼痛管理，4)营养管理，5)糖尿病，6)独居，7)搬到老年机构或医院时的协调。在研究中，222家造口诊所从538家机构中获得有效答案1096名有不同健康问题的患者在最近的造口诊所日就诊，47例(4.3%)使用探视护士制度。在研究中4。对25例接受家庭护理的患者进行造口管理因素分析。结论：L)支持患者群体，加强家庭造口管理教育是必要的。2)重视社区居家护理人员对医院护士的护理管理反馈，以达到最佳效果。

This study was conducted to find difficulty of home care and needs of ostomy patientsAim : To identify the issue for better care system of hospital and home care for ostomy patients Information collected through patient groups and stoma care nurses.Methods: In research 1, patient groups (Japan Ostomy Association and IBD patient groups),investigation using questionnaire. In research2, investigation using questionnaire' which consisted of nursing career and demographic data, ostomy care related factor, health care problem of ostomy patients. In researchS, investigation stoma care continuous system in Japan using questionnaire which consisted ofstoma clinic starting period, background of staff, type of patients etc In research4, investigated current health status of ostomy patients receiving home care.Results: In research1, data analyzed of 205 ostomy Association members and 685 IBD patients : In research.2, 1115 questionnaires distributed to stoma care nurses, 1034 valid answers returned (92 7%) Educational needs of higher-skilled nursing were l) stoma site marking, 2) selection of ostomy equipment 3) self-care education. High ratio of health care problems of ostomy patients in actual practice, 1) recurrence of cancer, 2) aged caring for aged problem, 3) cancer pain management 4) nutritional management, 5) diabetes mellitus, 6) live alone, 7) coordination when moving to elderly facilities or hospitals. In research^, 222 stoma clinics returned valid answers from 538 facilities 1096 patients who had varying health problems visited their stoma clinic on nearest stoma clinic day; 47 (4.3%) used visiting nurse system. In research4. 25 patients receiving home care, analyzed their stoma management factors.Conclusion: l) Support of patient group and promotion of education for home stoma care management are essential. 2) Feed back of the care management from community home care staff to hospital nurses is important, to achieve best results.