The Factors Analysis and Methods of Judgement for Urgent Problems of Patients with Incurable Disease

目的与方法本研究有两个目的，一是比较紧急问题发生组与未发生组（对照组）的背景条件，二是对紧急问题进行因素分析和判断方法。研究对象为东京大都会神经科医院和冲绳县中央保健中心地区家庭护理的疑难杂症患者。发生组80例，对照组66例，时间分别为1983年和1985年2个月。两组的背景差异在于，发生组有以下几个显著点：(1)平均年龄高。(P <。(2)日常生活活动水平（ADL）偏低。(p <。05)(3)疾病状况较对照组差。(4)治疗频繁。(p <。05) 3。急迫问题的内容是疾病状况的变化（35）。（1%）、患者的家庭护理问题（21%）和其他问题（43.9%）。4 .对不治之症患者护理的优先指标是患者的年龄、疾病状况、生活自理水平、治疗频率、医疗保健状况、患者家中护理人员的状况。对患者紧急问题的判断和护理过程如下：(1)对患者和/或家属信息的确认(2)对紧急问题的判断(3)解决方案的规划(4)对患者的护理实践(5)对结果的确认

PURPOSES AND METHODSThis research has two purposes, the first is a comprison between background condition of the happening group and non-happening group(control group) of urgent problems, the second is a factor analysis and methods of judgement for urgent problems. The subjects are the home care patients with incurable diseases in Tokyo Metolopolitan Neurotic Hospital and the region of Central Health Center in Okinawa Prefecture.RESULTS1. The happening group has 80 patients and the control group has 66 patients during two months in 1983 and 1985.2. The differences in background of the two groups are that the happening group has the following remarkable points: (1) average age is high. (P<. 05) (2) level of activities in daily living (ADL) are low. (p<. 05) (3) Condition of disease is worse than control group. (4) Treatment are frequent. (p<. 05)3. The contents of urgent problems are change of disease condition (35. 1%), prblems with the patient' family care (21%) and others (43.9%).4. The priority index of care for the patients with incurable diseases are patient's age, condition of disease, level of ADL, frequency of treatments, condition of medical care, condition of care person at the paient's home.5.The process of judgement and care for the urgent problems of the patients are the follow: (1) confirmation of information from patients and/or their families (2) judgement of the urgent problems (3) planning of the solutions (4) practice for the caring of the patients (5) confirmation of the results